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North Dakota Medicaid

Does North Dakota Medicaid cover Wegovy for Liver Disease (MASH)?

Yes. North Dakota Medicaid covers Wegovy for liver disease (MASH) 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: Wegovy for Liver Disease (MASH) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

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
  • Renewal: 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 · View policy document (PDF)

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Questions people ask
Does North Dakota Medicaid cover Wegovy?
Yes. North Dakota Medicaid covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Wegovy approval last with North Dakota Medicaid?
Liver Disease (MASH) — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months.
What does North Dakota Medicaid require to renew Wegovy?
Liver Disease (MASH) — Applies to Medicaid plans. 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.
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 North Dakota Medicaid: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: BCBS North Dakota, Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth

All insurance plans · All medications

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