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Nevada Medicaid

Does Nevada Medicaid cover Ozempic for Heart Disease Risk Reduction?

Yes. Nevada Medicaid covers Ozempic for heart disease risk reduction with prior authorization. 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 3, 2026. How we verify · Check your exact plan

Full requirements: Ozempic 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.

CV risk reduction in T2DM with established CVD

All of:

  • Diagnosis of type 2 diabetes mellitus (T2DM)
  • Established cardiovascular disease
  • Documentation of A1C lab results within past 180 days
  • No history of pancreatitis
  • Prescribed at FDA-approved dose for T2DM indication
  • Recipient is appropriate age per FDA label

Documentation to bring

  • Documentation of T2DM diagnosis
  • Documentation of established cardiovascular disease
  • A1C lab result within past 180 days
  • Confirmation of no history of pancreatitis

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Documentation of positive response from therapy; recipient continues to meet all initial criteria.

Not covered when

  • History of pancreatitis
  • Prescribing for weight loss in absence of T2DM indication
  • Type 1 diabetes

Policy note: This CV risk reduction pathway under the Incretin Mimetics class criteria requires T2DM diagnosis (unlike Wegovy's CV risk exception which explicitly excludes diabetic patients). The class-level criteria cover CV risk reduction only for recipients WITH T2DM and established CVD. Appropriate age per FDA label required.

Policy effective April 6, 2026 · verified June 3, 2026 · source: Msm 1200 26 04 06 · View policy document (PDF)

Open on its own page →

Questions people ask
Does Nevada Medicaid cover Ozempic?
Yes. Nevada Medicaid covers Ozempic for heart disease risk reduction with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Nevada Medicaid?
Heart Disease Risk Reduction — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months.
What does Nevada Medicaid require to renew Ozempic?
Heart Disease Risk Reduction — Applies to Medicaid plans. Documentation of positive response from therapy; recipient continues to meet all initial criteria.
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 Nevada Medicaid: Mounjaro, Wegovy, Zepbound

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

All insurance plans · All medications

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