Medicaid
Covered with requirementsWhat you need to qualify
- Trial of metformin for at least 90 days, or a documented reason it can't be used (["ASCVD", "ASCVD risk factors"])
- Prior trial of another GLP-1 medication (exenatide, Rybelsus, Trulicity, and Victoza) for at least 90 days
Qualification pathways
You can qualify through any one of these.
Non-preferred GLP-1: Metformin + preferred GLP-1 trial required
All of:
- Trial and failure of metformin >= 90-day supply in the last 12 months (unless ASCVD or ASCVD risk factors present)
- 90-day trial and failure of a preferred GLP-1 agent (exenatide, Rybelsus, Trulicity, or Victoza)
Exception: ASCVD or ASCVD risk factors — metformin trial waived
All of:
- 90-day trial and failure of a preferred GLP-1 agent
Plus any one of:
- Diagnosis of ASCVD
- Presence of ASCVD risk factors
Documentation to bring
- Documentation of metformin trial >= 90-day supply in the last 12 months, OR documentation of ASCVD or ASCVD risk factors to waive metformin requirement
- Documentation of 90-day trial and failure of a preferred GLP-1 agent (exenatide, Rybelsus, Trulicity, or Victoza)
Quantity limits
- 2mg/week — 2mg/week (dosage limit: maximum 2mg/week)
Policy note: Ozempic is listed as a non-preferred agent under Incretin Mimetics (GLP-1 Receptor Agonists) on the Wyoming Medicaid PDL. A dosage limit of 2mg/week applies. Approval requires prior trial and failure of metformin (>= 90 days) AND a preferred GLP-1 agent (>= 90 days), unless ASCVD or ASCVD risk factors are present (in which case metformin trial is waived). The preferred GLP-1 agents listed are: exenatide, Rybelsus, Trulicity, Victoza. Liraglutide is noted as 'use brand' (Victoza). Mounjaro and Zepbound are not mentioned in this document. Wegovy is not mentioned in this document.
Policy effective April 15, 2026 · verified June 4, 2026 · source: pdl-2026-041526.pdf