Skip to content

Missouri Medicaid

Does Missouri Medicaid cover Ozempic for Type 2 Diabetes?

Yes. Missouri Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered (preferred drug). See the qualification pathways below.

Earliest policy review June 3, 2026. How we verify · Check your exact plan

Full requirements: Ozempic for Type 2 Diabetes (1 plan type)

Applies to Medicaid plans.

Covered (preferred drug)

Qualification pathways

You can qualify through any one of these.

Preferred agent — metformin trial

All of:

  • Ozempic is a preferred agent
  • Adequate therapeutic trial of metformin in the past year

Preferred agent — prior GLP-1 history

All of:

  • Ozempic is a preferred agent
  • Prior history with a GLP-1 agonist in the past 3 months

Documentation to bring

  • Documentation of adequate therapeutic trial of metformin in the past year OR documentation of prior GLP-1 agonist use in the past 3 months

Quantity limits

  • 0.25 mg/dose, 0.5 mg/dose (1.5 mL pen) — 1.5 mL per 28 days
  • 0.25 mg/dose (2 mg/3 mL pen), 1 mg/dose (2 mg/1.5 mL pen), 1 mg/dose (4 mg/3 mL pen), 2 mg/dose (8 mg/3 mL pen) — 3 mL per 28 days

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months

Not covered when

  • Concurrent therapy with another GLP-1 receptor agonist

Policy note: Ozempic is a preferred agent on the MO HealthNet PDL. For preferred agents, approval requires either an adequate therapeutic trial of metformin in the past year OR prior history with a GLP-1 agonist in the past 3 months. Denial code '0160' (Preferred Drug List) applies when criteria not met. GLP-1 receptor agonists indicated for anti-obesity/obesity are covered under a separate PDL edit.

Policy effective January 9, 2025 · verified June 3, 2026 · source: Policy 310 · View policy document (PDF)

Open on its own page →

Questions people ask
Does Missouri Medicaid cover Ozempic?
Yes. Missouri Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Missouri Medicaid?
Type 2 Diabetes — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months.
How current is this information?
The oldest review date among the policies on this page is June 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Missouri Medicaid: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: Elevance Health, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid

All insurance plans · All medications

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