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Oklahoma Medicaid

Does Oklahoma Medicaid cover Ozempic for Type 2 Diabetes?

Yes. Oklahoma 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.

GLP-1 Special PA for T2DM — stabilized on requested product

All of:

  • FDA approved diagnosis of type 2 diabetes mellitus
  • Member is currently stabilized on the requested product (documentation must be provided)

GLP-1 Special PA for T2DM — cannot use lower-tiered GLP-1/GIP-GLP-1 agonists

All of:

  • FDA approved diagnosis of type 2 diabetes mellitus
  • Patient-specific, clinically significant reason (other than convenience) why member cannot use all available lower-tiered GLP-1 or GIP/GLP-1 agonists

Documentation to bring

  • Documentation of FDA approved type 2 diabetes mellitus diagnosis
  • Documentation that member is currently stabilized on the requested product OR patient-specific, clinically significant reason why member cannot use all available lower-tiered GLP-1 or GIP/GLP-1 agonists

Policy note: Ozempic (semaglutide injection) appears in the GIP/GLP-1 Agonists table as a Tier-2 brand-preferred product. The Special PA criteria for GLP-1 Agonists and GIP/GLP-1 Agonists apply when Ozempic is the subject of the PA request. A clinical exception applies for medications with a unique FDA approved indication not covered by all Tier-2 and Tier-3 GLP-1 or GIP/GLP-1 agonists. Tier-2 antidiabetic approval criteria also underlie the GLP-1 tier structure: T2DM diagnosis required plus at least 3-month metformin trial (unless intolerable) or clinically significant reason metformin is not appropriate. No quantity limits are specified in this document for Ozempic specifically.

verified June 4, 2026 · source: Policy 385 · View policy document (PDF)

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Questions people ask
Does Oklahoma Medicaid cover Ozempic?
Yes. Oklahoma 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 Oklahoma Medicaid: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: HCSC, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid

All insurance plans · All medications

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