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Nebraska Medicaid

Does Nebraska Medicaid cover Ozempic?

Yes. Nebraska 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 4, 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: Type 2 Diabetes with Metformin Trial

All of:

  • Diagnosis of Type II diabetes

Plus any one of:

  • Trial and failure of metformin
  • Intolerance to metformin

Preferred Agent: Type 2 Diabetes with ASCVD (no metformin trial required)

All of:

  • Diagnosis of Type II diabetes
  • Diagnosis of ASCVD associated with Type II diabetes

Documentation to bring

  • Documentation of Type II diabetes diagnosis
  • Documentation of metformin trial and failure or intolerance, OR documentation of ASCVD associated with Type II diabetes

Policy note: Ozempic appears on BOTH the Preferred and Non-Preferred lists. As a preferred agent, it requires T2DM diagnosis plus metformin trial/failure/intolerance, OR T2DM with ASCVD (no metformin trial required). The document also lists Ozempic as a non-preferred agent with notation 'AL, NR, QTAB' — this likely refers to a specific formulation (tablet/oral form, i.e., Rybelsus-like oral semaglutide) or a second listing; the non-preferred criteria require failure of TWO preferred GLP-1 RA agents, HbA1C ≥ 7, and metformin trial or contraindication/intolerance. The preferred injectable Ozempic (semaglutide) pen is captured here. Age limit (AL) and quantity limit (QL) are noted but specific values are not detailed in this document excerpt. The document includes an 'AL' flag indicating an age limit applies, but the specific age threshold is not stated in the provided text.

Policy effective June 1, 2026 · verified June 4, 2026 · source: Ne Pdl 20260601 · View policy document (PDF)

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Questions people ask
Does Nebraska Medicaid cover Ozempic?
Yes. Nebraska Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
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.

Also under Nebraska Medicaid: Mounjaro

Ozempic under other plans: BCBS Nebraska, Molina Healthcare, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid

All insurance plans · All medications

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