Does Colorado Medicaid cover Zepbound?

Quick answer · Osa

Colorado Medicaid covers Zepbound for osa with prior authorization on Medicaid.

The card and program names below are mapped to Colorado Medicaid in our records. Coverage depends on the reason for treatment and the requirements in the policy.

Policy last verified June 4, 2026. Policy effective March 1, 2023. Source: 04-01-26%20PDL%20V1.pdf. How we verify this data.

Card and program names on file in Colorado

Select a name to read the Colorado Medicaid policy for Zepbound. These are names we recognize, including older names and spelling variants; this is not a list of plans currently accepting members.

Don't see your card name? Check your card or call the pharmacy-benefit number on your card. If you also have Medicare, confirm which plan handles this prescription.

Zepbound for Osa

Medicaid

Covered with requirements

What you need to qualify

  • Age 18 and older
  • BMI of 30 or higher
  • Diagnosis documented with a code
  • Diagnosed obstructive sleep apnea, with a documented trial of PAP therapy

Policy note: Non-preferred. OSA: age >=18, BMI >=30 documented, OSA confirmed by approved sleep test, not pregnant, MTC/MEN2 counseling, engaged in lifestyle modification, AND failed a 6-month trial of CPAP. Reauthorization requires documented clinical improvement in OSA symptoms + adherence.

Policy effective March 1, 2023 · verified June 4, 2026 · source: 04-01-26%20PDL%20V1.pdf

Full Colorado Medicaid coverage page for Zepbound

Other medications under Colorado Medicaid

All insurance plans · All medications

This page summarizes written Medicaid policies on file. It is not a guarantee of coverage or medical advice. Confirm your current benefits and prior-authorization requirements with your plan.