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Minnesota Medicaid

Does Minnesota Medicaid cover Wegovy?

Yes. Minnesota Medicaid covers Wegovy for weight loss with prior authorization if your BMI is 30 or higher, or 27 or higher with a related condition. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered with requirements. See the qualification pathways below.

Earliest policy review June 4, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Weight Loss (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Initial Approval — Adult (≥18 years)

All of:

  • Patient meets age limit per FDA-approved label
  • Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity unless medically contraindicated
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks
  • No concurrent use of any other weight loss drug(s)
  • Patient's weight at baseline (in kg) submitted at time of request

Plus any one of:

  • BMI ≥ 30 kg/m2 with no risk factors
  • BMI ≥ 27 kg/m2 with at least one weight-related comorbid condition (hypertension, T2DM, or dyslipidemia)

Initial Approval — Adolescent (12-17 years)

All of:

  • Patient meets age limit per FDA-approved label
  • BMI ≥ 30 kg/m2 AND body weight above 60 kg
  • Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity unless medically contraindicated
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks
  • No concurrent use of any other weight loss drug(s)
  • Patient's weight at baseline (in kg) submitted at time of request

Renewal — Adult (≥18 years)

All of:

  • At least 5% weight loss during the initial approval period
  • Documentation of ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of ongoing regimen of increased physical activity unless medically contraindicated
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks

Renewal — Adolescent (12-17 years)

All of:

  • At least 5% reduction in baseline BMI during the initial approval period
  • Documentation of ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of ongoing regimen of increased physical activity unless medically contraindicated
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks

Subsequent Renewal (beyond 18 months)

All of:

  • Meets all standard renewal criteria
  • Documentation that patient maintains weight loss achieved during the initial approval period

Documentation to bring

  • Baseline BMI documentation (≥30 kg/m2 without comorbidity, or ≥27 kg/m2 with at least one weight-related comorbidity for adults; ≥30 kg/m2 and body weight >60 kg for ages 12-17)
  • Patient's baseline weight in kg
  • Documentation of initiation of or ongoing reduced calorie diet OR documentation of ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity (or medical contraindication)
  • Documentation that no concurrent weight loss drugs are being used
  • At renewal: documentation of ≥5% weight loss (adults) or ≥5% BMI reduction (adolescents) during initial approval period
  • At subsequent renewals (beyond 18 months): documentation that weight loss achieved during initial approval period is maintained

Quantity limits

  • per FDA-approved label — Per FDA-approved label quantity limits

Approval and renewal

  • Initial approval: 6 months
  • Renewal: every 12 months
  • Renewal: At least 5% reduction in BMI.
  • Renewal: Adults (≥18): at least 5% weight loss during initial approval period. Adolescents (12-17): at least 5% reduction in baseline BMI during initial approval period. Subsequent renewals beyond 18 months require meeting all renewal criteria plus documentation that patient maintains weight loss achieved during initial approval period.

Not covered when

  • No concurrent use of any other weight loss drug(s)
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks

Policy note: This policy is published by Minnesota Medicaid (MHCP). The Anti-Obesity Medications PA criteria page (March 2023) lists Wegovy as a covered drug requiring PA. Initial approval is 6 months; renewal is 12 months. The BMI percentile criterion (≥30 kg/m2 and body weight >60 kg for ages 12-17) is a proxy pediatric threshold rather than a stated percentile. All drugs on the Anti-Obesity list require prior authorization. The preferred/non-preferred status is deferred to the Preferred Drug List.

Policy effective March 1, 2023 · verified June 4, 2026 · source: Policy 372 · View policy document (PDF)

Open on its own page →

Full requirements: Wegovy for Heart Disease Risk Reduction (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MACE Risk Reduction — Initial and Renewal (up to 12 months)

All of:

  • Requested drug is FDA approved for MACE
  • Diagnosis of obesity or overweight
  • Patient meets age limit per FDA-approved label
  • Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity unless medically contraindicated by co-morbidity
  • No concurrent use of any other GLP-1 receptor agonist
  • Diagnosis of established cardiovascular (CV) disease
  • Documentation of management of CV risk factors
  • Requested agent is prescribed by or in consultation with a cardiologist

Documentation to bring

  • Documentation that requested drug is FDA approved for MACE indication
  • Documentation of diagnosis of obesity or overweight
  • Documentation of established cardiovascular (CV) disease
  • Documentation of management of CV risk factors
  • Documentation of initiation of or ongoing reduced calorie diet OR documentation of ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity (or medical contraindication)
  • Documentation that no concurrent GLP-1 receptor agonist is being used
  • Prescription by or documentation of consultation with a cardiologist

Quantity limits

  • per FDA-approved label — Per FDA-approved label quantity limits

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: The Weight Management Agents page states initial and renewal approval is up to 12 months; no specific weight-loss threshold is stated for the MACE indication renewal — criteria must be re-met at renewal.

Not covered when

  • No concurrent use of any other GLP-1 receptor agonist

Policy note: This MACE criterion is published on the Weight Management Agents PA criteria page (May 2026 version) by Minnesota Medicaid (MHCP). The policy requires established CV disease but does not specify individual qualifying CV events. Management of CV risk factors is required but specific GDMT medications are not enumerated. Cardiologist prescribing or consultation is required.

Policy effective March 1, 2023 · verified June 4, 2026 · source: Policy 372 · View policy document (PDF)

Open on its own page →

Full requirements: Wegovy for Liver Disease (MASH) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MASH — Initial and Renewal (up to 12 months)

All of:

  • Requested drug is FDA approved for MASH
  • Patient meets age limit per FDA-approved label
  • Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity unless medically contraindicated by co-morbidity
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks
  • No concurrent use of any other GLP-1 receptor agonist
  • Diagnosis of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH)
  • Moderate to advanced liver fibrosis consistent with stages F2 to F3 fibrosis
  • Requested agent is prescribed by or in consultation with a gastroenterologist or hepatologist

Documentation to bring

  • Documentation that requested drug is FDA approved for MASH indication
  • Documentation of diagnosis of noncirrhotic MASH
  • Documentation of moderate to advanced liver fibrosis consistent with stages F2-F3
  • Documentation of initiation of or ongoing reduced calorie diet OR documentation of ongoing care of a registered dietitian nutritionist
  • Documentation of initiation of or ongoing regimen of increased physical activity (or medical contraindication)
  • Documentation that no concurrent GLP-1 receptor agonist is being used
  • Documentation of no contraindications (or prescriber attestation that benefits outweigh risks)
  • Prescription by or documentation of consultation with a gastroenterologist or hepatologist

Quantity limits

  • per FDA-approved label — Per FDA-approved label quantity limits

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: The Weight Management Agents page states initial and renewal approval is up to 12 months; no specific continuation threshold beyond re-meeting criteria is stated for the MASH indication.

Not covered when

  • No concurrent use of any other GLP-1 receptor agonist
  • Cirrhotic MASH is excluded (noncirrhotic only)
  • No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks

Policy note: This MASH criterion is published on the Weight Management Agents PA criteria page (May 2026 version) by Minnesota Medicaid (MHCP). The policy specifies F2-F3 fibrosis (moderate to advanced) but does not detail the confirmation methodology (e.g., FIB-4, FibroScan, biopsy). Gastroenterologist or hepatologist prescribing or consultation is required. The policy explicitly excludes cirrhotic MASH ('noncirrhotic').

Policy effective March 1, 2023 · verified June 4, 2026 · source: Policy 372 · View policy document (PDF)

Open on its own page →

Questions people ask
Does Minnesota Medicaid cover Wegovy?
Yes. Minnesota Medicaid covers Wegovy for weight loss with prior authorization if your BMI is 30 or higher, or 27 or higher with a related condition. Other policy requirements and your plan's benefits also apply.
How long does a Wegovy approval last with Minnesota Medicaid?
Weight Loss — Applies to Medicaid plans. Initial approval: 6 months. Renewal: every 12 months. Heart Disease Risk Reduction — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months. Liver Disease (MASH) — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months.
What does Minnesota Medicaid require to renew Wegovy?
Weight Loss — Applies to Medicaid plans. At least 5% reduction in BMI. Adults (≥18): at least 5% weight loss during initial approval period. Adolescents (12-17): at least 5% reduction in baseline BMI during initial approval period. Subsequent renewals beyond 18 months require meeting all renewal criteria plus documentation that patient maintains weight loss achieved during initial approval period. Heart Disease Risk Reduction — Applies to Medicaid plans. The Weight Management Agents page states initial and renewal approval is up to 12 months; no specific weight-loss threshold is stated for the MACE indication renewal — criteria must be re-met at renewal. Liver Disease (MASH) — Applies to Medicaid plans. The Weight Management Agents page states initial and renewal approval is up to 12 months; no specific continuation threshold beyond re-meeting criteria is stated for the MASH indication.
How current is this information?
The oldest review date among the policies on this page is June 4, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Wegovy under other plans: BCBS Minnesota, Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth

All insurance plans · All medications

Summary of Minnesota Medicaid's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.