Virginia Medicaid

Does Virginia Medicaid cover Wegovy?

Find your Medicaid card name in Virginia

Quick answer · Weight Loss

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

  • Medicaid: Covered with requirements. No additional clinical requirements listed.

Last verified June 4, 2026. Policy effective April 1, 2026. Source: VAmed-PDL-List-Criteria-20260401-v6.pdf. How we verify this data →

Check your card for your exact plan →

Wegovy for Weight Loss

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

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

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

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)

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

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

Why Wegovy requests get denied by Virginia Medicaid

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

  1. Wrong brand for the diagnosis. Wegovy and Ozempic are the same molecule with different approved uses; a request for Wegovy under a diagnosis that matches Ozempic is routinely denied.

Frequently asked questions

Does Virginia Medicaid cover Wegovy?
Virginia Medicaid covers Wegovy for weight loss with prior authorization on Medicaid.
How current is this information?
This page reflects Virginia Medicaid's written policy as of April 1, 2026, last verified against the source document on June 4, 2026.

Other medications under Virginia Medicaid

Wegovy coverage under other plans

All insurance plans · All medications

This page summarizes Virginia 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.