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West Virginia Medicaid

Does West Virginia Medicaid cover Zepbound for Weight Loss?

No. West Virginia Medicaid's policies on file exclude Zepbound for weight loss on Medicaid plans.

Policy document

  • West Virginia Medicaid Medicaid prior authorization policy

    West Virginia Medicaid · PA policy · Medicaid

    Effective July 1, 2025. Verified June 3, 2026.

    View PDF Download Original insurer source
  • Medicaid: Not covered. Agents used for the purpose of weight loss are typically a benefit exclusion and not covered by West Virgin...

Earliest policy review June 3, 2026. How we verify · Check your exact plan

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

Applies to Medicaid plans.

Not covered

Agents used for the purpose of weight loss are typically a benefit exclusion and not covered by West Virginia Medicaid. Coverage of Zepbound will only be considered for a diagnosis of OSA in adults with obesity.

Policy note: West Virginia Medicaid explicitly excludes weight loss as a covered indication for Zepbound. Coverage is only considered for OSA in adults with obesity.

Policy effective July 1, 2025 · verified June 3, 2026 · source: West Virginia Medicaid Medicaid prior authorization policy · View policy document (PDF)

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If weight loss isn't covered on your plan

A prior authorization can't override a benefit exclusion. Ask West Virginia Medicaid about a formulary exception.

Questions people ask
Does West Virginia Medicaid cover Zepbound?
No. West Virginia Medicaid's policies on file exclude Zepbound for weight loss on Medicaid plans.
How current is this information?
The oldest review date among the policies on this page is June 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under West Virginia Medicaid: Mounjaro, Ozempic, Wegovy

Zepbound under other plans: Highmark, Alabama Medicaid, California Medicaid, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, Illinois Medicaid, Indiana Medicaid

All insurance plans · All medications

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