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Pennsylvania Medicaid

Does Pennsylvania Medicaid cover Zepbound for Weight Loss?

No. Pennsylvania Medicaid's policies on file exclude Zepbound for weight loss on Medicaid plans.

Policy document

  • Medicaid: Not covered. Effective January 1, 2026, drugs containing a GLP-1 receptor agonist are not covered for the treatment of o...

Earliest policy review June 4, 2026. How we verify · Check your exact plan · Medicaid card names in Pennsylvania

Full requirements: Zepbound for Weight Loss (1 plan type)

Applies to Medicaid plans.

Not covered

Effective January 1, 2026, drugs containing a GLP-1 receptor agonist are not covered for the treatment of overweight or obesity for MA beneficiaries. The policy states: 'GLP-1 Receptor Agonists are not covered for the treatment of overweight or obesity.'

Policy note: Pennsylvania MA explicitly ended coverage of all GLP-1 receptor agonists for overweight/obesity effective January 1, 2026. Class-wide exclusion applies to Zepbound for weight loss indication.

Policy effective January 1, 2026 · verified June 4, 2026 · source: Mab2025112403 · View policy document (PDF)

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If weight loss isn't covered on your plan

A prior authorization can't override a benefit exclusion. Ask Pennsylvania Medicaid about a formulary exception.

Questions people ask
Does Pennsylvania Medicaid cover Zepbound?
No. Pennsylvania Medicaid's policies on file exclude Zepbound for weight loss on Medicaid plans.
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.

Card and program names on file in Pennsylvania

These names map to Pennsylvania Medicaid, including older names and spelling variants. This is not a list of plans currently accepting members.

Also under Pennsylvania Medicaid: Mounjaro, Ozempic, Wegovy

Zepbound under other plans: Capital BlueCross, Highmark, Alabama Medicaid, California Medicaid, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, Illinois Medicaid

All insurance plans · All medications

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