Vermont Medicaid

Does Vermont Medicaid cover Ozempic?

Quick answer · Type 2 Diabetes

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

  • Medicaid: Covered with requirements. Prior trial of another GLP-1 medication (Exenatide, Mounjaro, Rybelsus, Trulicity, and Victoza) for at least 84 days

Last verified June 4, 2026. Policy effective April 17, 2026. Source: Vermont-PDL-20260417.pdf. How we verify this data →

Check your card for your exact plan →

Ozempic for Type 2 Diabetes

What Vermont Medicaid requires, by plan type. Open this indication on its own page →

Medicaid

Covered with requirements

What you need to qualify

  • Prior trial of another GLP-1 medication (Exenatide, Mounjaro, Rybelsus, Trulicity, and Victoza) for at least 84 days

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.pdf

Why Ozempic requests get denied by Vermont Medicaid

Based on what this policy asks for. Fix these before the first submission.

  1. Wrong brand for the diagnosis. Ozempic and Wegovy are the same molecule with different approved uses; a request for Ozempic under a diagnosis that matches Wegovy is routinely denied.
  2. Required prior medication trials not documented.

Frequently asked questions

Does Vermont Medicaid cover Ozempic?
Vermont Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.
How current is this information?
This page reflects Vermont Medicaid's written policy as of April 17, 2026, last verified against the source document on June 4, 2026.

Other medications under Vermont Medicaid

Ozempic coverage under other plans

All insurance plans · All medications

This page summarizes Vermont Medicaid's written prior-authorization policy. It is not a guarantee of coverage; plans vary by employer and benefit design. Verify with your plan before relying on it.