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Oklahoma Medicaid

Does Oklahoma Medicaid cover Wegovy for Liver Disease (MASH)?

Yes. Oklahoma 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 4, 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 — initial approval

All of:

  • FDA approved indication of noncirrhotic MASH
  • Member is 18 years of age or older
  • Moderate-to-advanced liver fibrosis (stage F2 or F3) confirmed by at least one accepted method
  • No chronic liver disease other than metabolic dysfunction-associated steatotic liver disease (MASLD)
  • No T1DM or T2DM
  • Metabolic comorbidities appropriately managed (T2DM, dyslipidemia, hypertension) as attested by prescriber
  • Not using Wegovy in combination with other semaglutide-containing products or any GLP-1 receptor agonist
  • Diet and exercise used in conjunction (clinical documentation required)
  • Prescribed by or in consultation with gastroenterologist or hepatologist (or advanced care practitioner supervised by gastroenterologist or hepatologist)

Plus any one of:

  • FibroScan with VCTE ≥ 8kPa and CAP ≥ 280dB/min
  • ELF biochemical test score ≥ 9
  • Liver biopsy showing stage F2 or F3 fibrosis with MASH

Documentation to bring

  • Results of fibrosis confirmation test (FibroScan VCTE with VCTE ≥8kPa and CAP ≥280dB/min, OR ELF score ≥9, OR liver biopsy showing F2 or F3 fibrosis with MASH)
  • Clinical documentation (e.g., office notes) of diet and exercise discussion with member
  • Prescriber attestation that metabolic comorbidities (T2DM, dyslipidemia, hypertension) are being appropriately managed
  • Confirmation member does not have chronic liver disease other than MASLD
  • Confirmation member does not have T1DM or T2DM
  • Confirmation member will not use Wegovy in combination with other semaglutide-containing products or any GLP-1 receptor agonist
  • Documentation that prescriber is or is in consultation with a gastroenterologist or hepatologist

Quantity limits

  • all injection strengths — 4 pens per 28 days

Approval and renewal

  • Initial approval: 2 months
  • Renewal: every 12 months
  • Renewal: Member is tolerating maintenance dosing; member has not developed T1DM or T2DM; member is continuing a reduced calorie diet and increased physical activity in conjunction with Wegovy. Note: MASH diagnosis and fibrosis staging are not explicitly re-verified at continuation per the document.
  • Renewal: Staying on a maintenance dose of at least 1.7 mg.

Not covered when

  • Type 2 diabetes mellitus (T2DM excluded — member must not have T1DM or T2DM)
  • Known liver cirrhosis (stage F4)
  • Chronic liver disease other than MASLD
  • Concurrent use with other semaglutide-containing products or any GLP-1 receptor agonist
  • Obese members without MASH will not be approved
  • Members who cannot tolerate dose escalation after additional 8-week approval will not be approved for continuation
  • Wegovy should be discontinued if member cannot tolerate at least 1.7mg once weekly maintenance dosing
  • Type 1 diabetes

Policy note: Initial approvals are for 8-week titration periods per dose; a separate PA must be submitted for each dose. An additional 8 weeks per dose may be approved for intolerable adverse effects during escalation with documentation. Subsequent (maintenance) approvals are for 1 year. FibroScan threshold for MASH is ≥8kPa (vs ≥8.5kPa for Rezdiffra criteria). The MASH indication criteria cover Wegovy injection only (not tablets). This document also requires a prior trial of Wegovy at maintenance dosing for at least 3 months as a step-therapy prerequisite for Rezdiffra (resmetirom) — but that is a step-therapy condition for Rezdiffra, not a Wegovy PA criterion. Last modified date on the Metabolic Disorders page is April 24, 2026.

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

Open on its own page →

Questions people ask
Does Oklahoma Medicaid cover Wegovy?
Yes. Oklahoma 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 Oklahoma Medicaid?
Liver Disease (MASH) — Applies to Medicaid plans. Initial approval: 2 months. Renewal: every 12 months.
What does Oklahoma Medicaid require to renew Wegovy?
Liver Disease (MASH) — Applies to Medicaid plans. Member is tolerating maintenance dosing; member has not developed T1DM or T2DM; member is continuing a reduced calorie diet and increased physical activity in conjunction with Wegovy. Note: MASH diagnosis and fibrosis staging are not explicitly re-verified at continuation per the document. Staying on a maintenance dose of at least 1.7 mg.
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, Ozempic, Zepbound

Wegovy under other plans: HCSC, Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth

All insurance plans · All medications

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