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Virginia Medicaid

Does Virginia Medicaid cover Zepbound?

Yes. Virginia Medicaid covers Zepbound for weight loss with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

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

Earliest policy review June 4, 2026. How we verify · Check your exact plan · Medicaid card names in Virginia

Full requirements: Zepbound for Weight Loss (1 plan type)

Applies to Medicaid plans.

Covered with requirements

See the original policy for clinical requirements.

Documentation to bring

  • Weight Management Agents SA Form

Policy note: Zepbound 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. Authorization length is 'as indicated on fax form'. Note: the document states 'The selected GLP-1 Receptor Agonist is injectable brand Wegovy' in the context of the CV risk reduction and likely MASH SA forms, which may mean Zepbound is not the selected agent for those indications.

Policy effective April 1, 2026 · verified June 4, 2026 · source: V Amed Pdl List Criteria 20260401 V6 · View policy document (PDF)

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Full requirements: Zepbound for Obstructive Sleep Apnea (OSA) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

What you need to qualify

  • Diagnosed obstructive sleep apnea

Documentation to bring

  • GLP-1 Receptor Agonist For Obstructive Sleep Apnea SA Form

Policy note: The document references a separate SA form titled 'GLP-1 Receptor Agonist For Obstructive Sleep Apnea 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'. Zepbound is listed as a Non-Preferred agent in the Weight Management Agents CLOSED CLASS section which references this OSA SA form.

Policy effective April 1, 2026 · verified June 4, 2026 · source: V Amed Pdl List Criteria 20260401 V6 · View policy document (PDF)

Open on its own page →

Questions people ask
Does Virginia Medicaid cover Zepbound?
Yes. Virginia Medicaid covers Zepbound for weight loss 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.

Card and program names on file in Virginia

These names map to Virginia Medicaid, including older names and spelling variants. This is not a list of plans currently accepting members.

Also under Virginia Medicaid: Wegovy

Zepbound under other plans: Elevance Health, Kaiser Permanente Mid-Atlantic, Alabama Medicaid, California Medicaid, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, Illinois Medicaid

All insurance plans · All medications

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