Does Michigan Medicaid cover Ozempic?

Quick answer · Type 2 Diabetes

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

The card and program names below are mapped to Michigan 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 July 1, 2026. Source: MIRx_clinical_criteria.pdf. How we verify this data.

Card and program names on file in Michigan

Select a name to read the Michigan 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

No additional clinical requirements are listed beyond the diagnosis.

Qualification pathways

You can qualify through any one of these.

Preferred Agent Criteria

All of:

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

Non-Preferred Agent Criteria

All of:

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

Plus any one of:

  • Allergy to the preferred medications
  • Contraindication or drug-to-drug interaction with the preferred medications
  • History of unacceptable side effects
  • Trial and failure with one preferred medication within same subgroup

Documentation to bring

  • Documentation of type 2 diabetes diagnosis
  • Documentation of discontinuation of other GLP-1 agonists
  • Documentation of discontinuation of DPP-4 inhibitors
  • If non-preferred: documentation of allergy, contraindication, drug interaction, unacceptable side effects, or trial and failure with a preferred agent in the same subgroup

Quantity limits

  • all strengths — 3 pens per 84 days (84-day)

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months

Policy note: Ozempic is listed in the Michigan Medicaid PDL under 'Diabetes: Incretin Mimetics and Combinations'. Preferred vs. non-preferred status is determined by the Michigan Preferred Drug List (PDL), which is referenced but not fully reproduced in this document. The criteria apply to the PDL class broadly. The 'discontinuation of other GLP-1 agonists' criterion means the patient must not be on another GLP-1 concurrently.

Policy effective July 1, 2026 · verified June 4, 2026 · source: MIRx_clinical_criteria.pdf

Full Michigan Medicaid coverage page for Ozempic

Other medications under Michigan 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.