Medicaid
Covered with requirementsWhat you need to qualify
- Prior trial of another GLP-1 medication (Ozempic)
- Prescribed by or in consultation with a specialist
- Confirmed MASH diagnosis by liver_biopsy, FibroScan_VCTE, ELF_test, and MRE, fibrosis stage F2 to F3
Qualification pathways
You can qualify through any one of these.
MASH - Wegovy injection (non-preferred, requires Ozempic 2mg tolerance)
All of:
- All general MASH initial criteria met (F2 or F3 fibrosis, specialist prescriber, no terminal diagnosis, alcohol criteria if applicable)
- Dose escalation to 2mg weekly of Ozempic (semaglutide) must be tolerated before Wegovy will be authorized
Documentation to bring
- Documentation of moderate to severe fibrosis (F2 or F3) by biopsy, FibroScan/VCTE, ELF, MRI-PDFF, or MRE
- Prescriber attestation of consultation with endocrinologist, gastroenterologist, or hepatologist
- Alcohol use history assessment; if history of alcohol use within past 5 years: PEth <20 ng/mL OR two negative alcohol tests (most recent within 3 months)
- Documentation that member does not have terminal diagnosis with life expectancy <1 year
- Documentation of dose escalation to Ozempic 2mg weekly tolerated
Approval and renewal
- Initial approval: 12 months
- Renewal: every 12 months
- To renew, the plan looks for Member must have experienced one of: (1) resolution of steatohepatitis AND no worsening of liver fibrosis; (2) improvement of liver fibrosis ≥1 stage AND no worsening of steatohepatitis; (3) both resolution of steatohepatitis AND improvement in fibrosis. Fibrosis and steatosis measured by biopsy, FibroScan/VCTE, ELF, MRI-PDFF, or MRE.
Not covered when
- Terminal diagnosis with life expectancy <1 year
- Fibrosis stage F0, F1, or F4 not covered - only F2 or F3
Policy note: Wegovy injection is listed as a NON-PREFERRED agent in the MASH section. Requires tolerance of Ozempic 2mg weekly dose escalation as a step therapy prerequisite before Wegovy authorization. All general MASH criteria (F2-F3 fibrosis, specialist, alcohol criteria, no terminal illness) must also be met.
Policy effective April 1, 2026 · verified June 3, 2026 · source: PDL-2026.4.pdf