Virginia Medicaid coverage for Wegovy (Heart Disease Risk Reduction)

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