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Priority Health

Does Priority Health cover Ozempic?

Yes. Priority Health 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 10, 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.

Preferred agent — clinical PA criteria

All of:

  • Diagnosis of type 2 diabetes
  • Discontinuation of other GLP-1 agonists
  • Discontinuation of DPP-4 inhibitors

Documentation to bring

  • Documentation of type 2 diabetes diagnosis
  • Confirmation of discontinuation of other GLP-1 agonists
  • Confirmation of discontinuation of DPP-4 inhibitors

Approval and renewal

  • Initial approval: 12 months

Policy note: Ozempic is listed as a preferred agent in the Incretin Mimetics class. Preferred agent PA criteria require T2DM diagnosis plus discontinuation of other GLP-1 agonists and DPP-4 inhibitors. Approval duration is up to 1 year.

Policy effective May 1, 2025 · verified June 10, 2026 · source: Medicaid Rx PA Criteria · View policy document (PDF)

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Questions people ask
Does Priority Health cover Ozempic?
Yes. Priority Health covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Priority Health?
Type 2 Diabetes — Applies to Medicaid plans. Initial approval: 12 months.
How current is this information?
The oldest review date among the policies on this page is June 10, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Priority Health: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: BCBS Michigan, Michigan Medicaid, Molina Healthcare, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid

All insurance plans · All medications

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