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Tennessee Medicaid

Does Tennessee Medicaid cover Wegovy for Liver Disease (MASH)?

Yes. Tennessee Medicaid covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered (preferred drug). See the qualification pathways below.

Earliest policy review June 3, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Liver Disease (MASH) (1 plan type)

Applies to Medicaid plans.

Covered (preferred drug)

Qualification pathways

You can qualify through any one of these.

Initial approval for NASH/MASH

All of:

  • Patient is 18 years of age or older
  • Diagnosis of NASH or MASH
  • Fibrosis stage F2 or F3 confirmed by an approved diagnostic method
  • Prescriber attests patient is participating in a supervised comprehensive weight management program
  • Prescribed by or in consultation with a gastroenterologist or hepatologist
  • Will not be used concomitantly with DPP-4 inhibitors
  • Will not be co-administered with another GLP-1 receptor agonist
  • No personal or immediate family history of medullary thyroid carcinoma or MEN2

Plus any one of:

  • Fibrosis confirmed by FibroScan
  • Fibrosis confirmed by Fibrosis-4 index (FIB-4)
  • Fibrosis confirmed by Magnetic Resonance Elastography (MRE)
  • Fibrosis confirmed by liver biopsy

Documentation to bring

  • Medical records (e.g., chart notes) confirming diagnosis of NASH or MASH
  • Medical records confirming fibrosis stage F2 or F3 via FibroScan, FIB-4, MRE, or liver biopsy
  • Prescriber attestation that patient is participating in a supervised comprehensive weight management program
  • Documentation of prescriber specialty (gastroenterologist or hepatologist) or consultation note
  • Documentation that patient has no personal or immediate family history of medullary thyroid carcinoma or MEN2

Quantity limits

  • 0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg — 4 injectors

Approval and renewal

  • Renewal: Positive clinical response required: improvement in NASH/MASH disease symptoms documented in recent medical records (chart notes and/or labs).

Not covered when

  • Personal or immediate family history of medullary thyroid carcinoma or MEN2
  • Concomitant use of DPP-4 inhibitors
  • Co-administration with another GLP-1 receptor agonist

Policy note: Document uses both NASH and MASH terminology interchangeably. Fibrosis stage must be F2 or F3 (not F1, F4, or cirrhotic). No specific lookback periods stated for diagnostic tests. Specialist requirement: prescribed by or in consultation with a gastroenterologist or hepatologist. Renewal only requires positive clinical response documentation; specialist, BMI, and fibrosis confirmation requirements are not explicitly re-verified at renewal.

Policy effective June 1, 2026 · verified June 3, 2026 · source: Criteria Pdl · View policy document (PDF)

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Questions people ask
Does Tennessee Medicaid cover Wegovy?
Yes. Tennessee Medicaid covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.
What does Tennessee Medicaid require to renew Wegovy?
Liver Disease (MASH) — Applies to Medicaid plans. Positive clinical response required: improvement in NASH/MASH disease symptoms documented in recent medical records (chart notes and/or labs).
How current is this information?
The oldest review date among the policies on this page is June 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Tennessee Medicaid: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth, Fallon Health Plan

All insurance plans · All medications

Summary of Tennessee Medicaid's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.