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Vermont Medicaid

Does Vermont Medicaid cover Ozempic?

Yes. Vermont Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered with requirements. See the qualification pathways below.

Earliest policy review June 4, 2026. How we verify · Check your exact plan

Full requirements: Ozempic for Type 2 Diabetes (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Non-preferred GLP-1 for Type 2 Diabetes — Step Through Preferred

All of:

  • Diagnosis of Type 2 Diabetes Mellitus

Plus any one of:

  • Documented side effect with a preferred GLP-1 product
  • Documented allergy to a preferred GLP-1 product
  • Documented contraindication to a preferred GLP-1 product
  • Treatment failure of a preferred GLP-1 product (defined as <1% reduction in HbA1c after 12 weeks at maximally tolerated dose)

Documentation to bring

  • Documentation of Type 2 Diabetes Mellitus diagnosis
  • Documentation of side effect, allergy, contraindication, or treatment failure with a preferred GLP-1 product

Quantity limits

  • all strengths — 9 mL/84 days (84-day)

Policy note: Ozempic is a non-preferred agent requiring PA. Patient must have documented side effect, allergy, contraindication, or treatment failure with a preferred GLP-1 product. Treatment failure is defined as <1% reduction in HbA1c after 12 weeks at the maximally tolerated dose. Prior glp1_trial duration days set to 84 based on the 12-week treatment failure definition.

Policy effective April 17, 2026 · verified June 4, 2026 · source: Vermont Pdl 20260417 · View policy document (PDF)

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Questions people ask
Does Vermont Medicaid cover Ozempic?
Yes. Vermont Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How current is this information?
The oldest review date among the policies on this page is June 4, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Vermont Medicaid: Mounjaro, Zepbound

Ozempic under other plans: Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth

All insurance plans · All medications

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