insurance requirements for glp-1 Coverage Statistics 2026 | Employer, Medicare & Medicaid Data How to check your Omada

Effective January 1, 2026, Medi-Cal Rx is excluding coverage for GLP-1 medications prescribed for weight loss: [12] Wegovy, Zepbound, Saxenda: Completely removed from the Contract Drugs List for weight loss Ozempic, Mounjaro, Rybelsus: Restricted to Type 2 diabetes onlyweight loss claims will auto-deny Existing prior authorizations end December 31, 2025 Exceptions: Members under age 21 may still qualify via EPSDT Non-weight-loss indications (Zepbound for OSA, Wegovy for cardiovascular) may still get PA approval This does NOT affect Kaiser commercial or employer-sponsored plansonly Medi-Cal members

These results raise fundamental questions about stability and potency of monotreme GLP-1

Step 3: Provider reviews your file and approves your prescription

Ozempic and Wegovy cost over $1,000 per month at retail without insurance