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Wyoming Medicaid

Does Wyoming Medicaid cover Zepbound?

Yes. Wyoming Medicaid covers Zepbound for obstructive sleep apnea (OSA) with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered (preferred drug). See the qualification pathways below.

Earliest policy review June 4, 2026. How we verify · Check your exact plan

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

Applies to Medicaid plans.

Covered (preferred drug)

Qualification pathways

You can qualify through any one of these.

OSA in obese adults

All of:

  • Diagnosis of moderate to severe obstructive sleep apnea
  • Patient is an obese adult
  • AHI > 15 as evidenced by sleep study within the prior 12 months

Documentation to bring

  • Documentation of diagnosis of moderate to severe obstructive sleep apnea
  • Sleep study performed within the prior 12 months showing AHI > 15
  • Documentation that patient is an obese adult
  • At 6-month renewal: documentation of at least 5% weight loss
  • At 12-month renewal: documentation of improvement in obstructive sleep apnea

Approval and renewal

  • Initial approval: 6 months
  • Renewal: every 6 months
  • Renewal: At 6-month renewal: at least 5% weight loss required. At 12-month renewal: demonstrated improvement in obstructive sleep apnea required.

Policy note: Zepbound is listed as a preferred GLP-1 agonist under the Obstructive Sleep Apnea therapeutic class on the Wyoming Medicaid PDL effective April 15, 2026. The policy requires a two-stage continuation review: re-authorization at 6 months requires at least 5% weight loss; re-authorization at 12 months requires demonstrated improvement in OSA. The policy states 'obese adults,' which implies an obesity requirement, but no explicit BMI threshold is stated. AHI > 15 is required (consistent with moderate-to-severe OSA). No PAP/CPAP trial is required per this document. The document does not address Zepbound for weight loss indication, so no entry is emitted for that indication.

Policy effective April 15, 2026 · verified June 4, 2026 · source: Pdl 2026 041526 · View policy document (PDF)

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Questions people ask
Does Wyoming Medicaid cover Zepbound?
Yes. Wyoming Medicaid covers Zepbound for obstructive sleep apnea (OSA) with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Zepbound approval last with Wyoming Medicaid?
Obstructive Sleep Apnea (OSA) — Applies to Medicaid plans. Initial approval: 6 months. Renewal: every 6 months.
What does Wyoming Medicaid require to renew Zepbound?
Obstructive Sleep Apnea (OSA) — Applies to Medicaid plans. At 6-month renewal: at least 5% weight loss required. At 12-month renewal: demonstrated improvement in obstructive sleep apnea required.
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.

Also under Wyoming Medicaid: Ozempic, Wegovy

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

All insurance plans · All medications

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