Wyoming Medicaid coverage for Wegovy (Liver Disease (MASH))

What you need to qualify

• Diagnosis documented with a code
• Confirmed MASH diagnosis

Qualification pathways

You can qualify through any one of these.

Documentation to bring

• Documentation of MASH diagnosis
• See Additional Therapeutic Criteria chart at www.wymedicaid.org for complete specific requirements

Policy note: Wegovy injectable is listed as a preferred agent for MASH on the Wyoming Medicaid PDL effective April 15, 2026. The PDL note states: 'Wegovy injectables will require diagnosis of MASH. Please consult the Additional Therapeutics Clinical Criteria chart for more information regarding cardiovascular disease criteria.' Full detailed MASH criteria are deferred to the Additional Therapeutic Criteria chart at www.wymedicaid.org, which is not included in this document. Rezdiffra is listed as a non-preferred agent for MASH but is not in scope for extraction.

Policy effective April 15, 2026 · verified June 4, 2026 · source: pdl-2026-041526.pdf