Does Georgia Medicaid cover Ozempic?

Quick answer · Type 2 Diabetes

Georgia Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.

The card and program names below are mapped to Georgia 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 December 8, 2025. Source: download. How we verify this data.

Card and program names on file in Georgia

Select a name to read the Georgia Medicaid policy for Ozempic. 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.

Ozempic for Type 2 Diabetes

Medicaid

Covered with requirements

What you need to qualify

  • Age 18 and older
  • A1C of 7% or higher
  • Diagnosis documented with a code
  • Prior trial of another GLP-1 medication (exenatide and Victoza)
  • Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

T2DM on background antidiabetic therapy with prior GLP-1 failure

All of:

  • Age >= 18 years
  • Diagnosis of type 2 diabetes mellitus
  • HbA1c >= 7%
  • Currently on metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione therapy
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide AND Victoza

T2DM with CKD with prior preferred SGLT2 and GLP-1 failure

All of:

  • Age >= 18 years
  • Diagnosis of type 2 diabetes mellitus
  • Chronic kidney disease (CKD)
  • HbA1c >= 7%
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to metformin AND SGLT2 inhibitor (Farxiga, Xigduo XR, or Jardiance)

T2DM with established cardiovascular disease with prior GLP-1 failure

All of:

  • Age >= 18 years
  • Diagnosis of type 2 diabetes mellitus
  • HbA1c >= 7%
  • Established cardiovascular disease (history of coronary artery disease, stroke, cerebrovascular disease, or peripheral artery disease)
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effect with Victoza

Documentation to bring

  • Documentation of type 2 diabetes mellitus diagnosis
  • HbA1c lab result >= 7%
  • For standard pathway: documentation of current background antidiabetic therapy (metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione)
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to Victoza
  • For CKD pathway: documentation of CKD diagnosis and failure of metformin and an SGLT2 inhibitor (Farxiga, Xigduo XR, or Jardiance)
  • For CVD pathway: documentation of established cardiovascular disease (coronary artery disease, stroke, cerebrovascular disease, or peripheral artery disease)

Policy note: Ozempic is listed as non-preferred under Miscellaneous Antidiabetic Agents. Three separate qualifying pathways exist: (1) standard T2DM on background therapy with exenatide and Victoza failure; (2) T2DM with CKD requiring metformin and SGLT2 inhibitor failure; (3) T2DM with established CVD requiring only Victoza failure. Ozempic itself is named as a required prior failure step for Mounjaro and Trulicity. Quantity level limits are referenced externally.

Policy effective December 8, 2025 · verified June 4, 2026 · source: download

Full Georgia Medicaid coverage page for Ozempic

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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.