Does Virginia Medicaid cover Wegovy?

Quick answer · Weight Loss

Virginia Medicaid covers Wegovy for weight loss with prior authorization on Medicaid.

The card and program names below are mapped to Virginia 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 April 1, 2026. Source: VAmed-PDL-List-Criteria-20260401-v6.pdf. How we verify this data.

Card and program names on file in Virginia

Select a name to read the Virginia Medicaid policy for Wegovy. 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.

Wegovy for Weight Loss

Medicaid

Covered with requirements

No additional clinical requirements are listed beyond the diagnosis.

Documentation to bring

  • Weight Management Agents SA Form

Policy note: Wegovy is listed as a Non-Preferred agent under the Weight Management Agents CLOSED CLASS. The SA criteria reference a 'Weight Management Agents SA Form' for full clinical criteria details, which are not reproduced in this document. The document also references separate SA forms for CV risk reduction, OSA, and MASH indications. Authorization length is 'as indicated on fax form'.

Policy effective April 1, 2026 · verified June 4, 2026 · source: VAmed-PDL-List-Criteria-20260401-v6.pdf

Wegovy for Heart Disease Risk Reduction

Medicaid

Covered with requirements

What you need to qualify

  • Established cardiovascular disease

Documentation to bring

  • GLP-1 Receptor Agonist For Cardiovascular Risk Reduction in Members with Obesity or Overweight SA Form

Policy note: The document references a separate SA form titled 'GLP-1 Receptor Agonist For Cardiovascular Risk Reduction in Members with Obesity or Overweight SA Form'. The indication is identified as cardiovascular risk reduction in members with obesity or overweight. Detailed clinical criteria are contained in the referenced fax form, not reproduced here. The document notes 'The selected GLP-1 Receptor Agonist is injectable brand Wegovy' for this indication. Authorization length is 'as indicated on fax form'.

Policy effective April 1, 2026 · verified June 4, 2026 · source: VAmed-PDL-List-Criteria-20260401-v6.pdf

Wegovy for Liver Disease (MASH)

Medicaid

Covered with requirements

What you need to qualify

  • Confirmed MASH diagnosis

Documentation to bring

  • GLP-1 Receptor Agonists for Metabolic Dysfunction-Associated Steatohepatitis SA Form

Policy note: The document references a separate SA form titled 'GLP-1 Receptor Agonists for Metabolic Dysfunction-Associated Steatohepatitis SA Form'. Detailed clinical criteria are contained in the referenced fax form and not reproduced in this PDL document. Authorization length is 'as indicated on fax form'. The document notes 'The selected GLP-1 Receptor Agonist is injectable brand Wegovy'.

Policy effective April 1, 2026 · verified June 4, 2026 · source: VAmed-PDL-List-Criteria-20260401-v6.pdf

Full Virginia Medicaid coverage page for Wegovy

Other medications under Virginia 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.