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New York Medicaid

Does New York Medicaid cover Ozempic for Type 2 Diabetes?

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

Policy on file; the document isn't available to view online yet.

  • 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.

Standard clinical criteria for GLP-1 agonist (T2DM)

All of:

  • Confirmed diagnosis of FDA-approved or compendia-supported indication that is also a Medicaid covered indication

Documentation to bring

  • Confirmation of FDA-approved or compendia-supported diagnosis that is a Medicaid covered indication
  • If concurrent GLP-1 and DPP-IV use: PA required with documentation of clinical rationale

Policy note: Ozempic is listed as a Preferred drug on the NYRx PDL under GLP-1 Receptor Agonists – Type 2 Diabetes with Clinical Criteria (CC). Clinical criteria require: (1) confirmed diagnosis of an FDA-approved or compendia-supported indication that is also a Medicaid covered indication; (2) PA is required if the patient is using a GLP-1 and DPP-IV concurrently. No additional quantitative criteria (A1C, BMI, step therapy) are specified in this document beyond those two requirements.

Policy effective April 23, 2026 · verified June 3, 2026 · source: Nyrx Pdp Pdl

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Questions people ask
Does New York Medicaid cover Ozempic?
Yes. New York 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 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under New York Medicaid: Mounjaro, Wegovy

Ozempic under other plans: Elevance Health, EmblemHealth, Excellus BCBS, Independent Health, Molina Healthcare, Alabama Medicaid, Arkansas Medicaid, California Medicaid

All insurance plans · All medications

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