Medicaid
Covered with requirementsWhat you need to qualify
- Age 18 and older
- A1C of 6.5% or higher
- Trial of metformin for at least 90 days, or a documented reason it can't be used (["intolerance", "contraindication", "clinically_inappropriate"])
- Prior trial of another GLP-1 medication (liraglutide) for at least 90 days
- Lab results confirming eligibility
Qualification pathways
You can qualify through any one of these.
Non-preferred agent (Ozempic) for T2DM — initial approval
All of:
- Diagnosis of type 2 diabetes OR HbA1c ≥ 6.5 within the last 12 months
- Patient is ≥ 18 years old
- Drug will not be used in combination with another GLP-1 agonist or DPP4 inhibitor
- History of failure (inability to achieve HbA1c < 7%) on metformin at maximum or highest tolerated dose for a minimum of 90 continuous days (unless not tolerated, contraindicated, or clinically inappropriate)
- History of failure (inability to achieve HbA1c < 7%) on liraglutide at maximum or highest tolerated dose for a minimum of 90 continuous days (unless not tolerated, contraindicated, or clinically inappropriate)
Documentation to bring
- Diagnosis of type 2 diabetes OR HbA1c lab result ≥ 6.5 within the last 12 months
- Documentation of patient age (≥ 18 years)
- Documentation confirming drug will not be combined with another GLP-1 agonist or DPP4 inhibitor
- Documentation of metformin trial at maximum or highest tolerated dose for ≥ 90 continuous days with inadequate response (HbA1c not achieving <7%), OR documentation of intolerance/contraindication/clinical inappropriateness
- Documentation of liraglutide trial at maximum or highest tolerated dose for ≥ 90 continuous days with inadequate response (HbA1c not achieving <7%), OR documentation of intolerance/contraindication/clinical inappropriateness
Quantity limits
- 0.25mg/0.5mL, 0.5mg/0.5mL, 1mg/0.5mL — 3 mL per 28 days (2 mg/3 mL pen injector)
- 1mg/0.5mL (4mg/3mL pen) — 3 mL per 28 days (4 mg/3 mL pen injector)
- 2mg/0.5mL (8mg/3mL pen) — 3 mL per 28 days (8 mg/3 mL pen injector)
Approval and renewal
- Initial approval: 12 months
- Renewal: every 12 months
- To renew, the plan looks for improvement in A1C and HbA1c ≤ 7 OR improved from baseline prior to GLP-1 treatment; diagnosis of T2DM confirmed; not used in combination with another GLP-1 agonist or DPP4 inhibitor. BMI and prior therapy step requirements are NOT re-verified at continuation.
Not covered when
- Concurrent use with another GLP-1 agonist
- Concurrent use with a DPP4 inhibitor
Policy note: Ozempic is a non-preferred agent on the Apple Health PDL. As a non-preferred brand, it requires step-through of BOTH metformin AND liraglutide (the preferred agents) for the standard T2DM indication. The a1c_min of 6.5 reflects the diagnostic threshold; the step-therapy failure threshold is HbA1c remaining ≥ 7% despite preferred agents. A1c must have been measured within the last 12 months.
Policy effective June 1, 2026 · verified June 4, 2026 · source: antidiabetics-GLP-1-agonists.pdf