Does every state Medicaid program cover GLP-1s for obesity?

No. KFF’s January 2026 fee-for-service survey found obesity coverage in a limited set of states, with some additional states covering under heavy restrictions, and several states dropping coverage in January 2026. Managed-care plans within a state can differ from the fee-for-service policy.

Are GLP-1s covered by Medicaid for type 2 diabetes?

Yes. GLP-1s prescribed for type 2 diabetes are covered by every state Medicaid program. That coverage is federally required, not optional, regardless of a state’s obesity-coverage policy.

Does Medicaid cover compounded semaglutide or tirzepatide?

No. Compounded semaglutide and tirzepatide is not covered by Medicaid in any state — it is cash-pay only.

If my state covers GLP-1s for obesity, will I automatically be approved?

No. Even in covering states, expect prior authorization, BMI thresholds, and documentation of prior weight-loss attempts. Confirm current status with your state Medicaid office.

Medicaid GLP-1 Coverage by State

Last checked against KFF's January 2026 survey

This applies to obesity/weight-loss coverage specifically. GLP-1s prescribed for type 2 diabetes are covered by every state Medicaid program regardless of what's below — that coverage is federally required, not optional.

States covering GLP-1s for obesity (fee-for-service)

State	Status
Delaware	Covers (with prior auth)
Minnesota	Covers (with prior auth)
Mississippi	Covers (with prior auth)
Missouri	Covers (with prior auth)
North Carolina	Covers (with prior auth)
Rhode Island	Covers (with prior auth)
Tennessee	Covers (with prior auth)
Utah	Covers (with prior auth)
Virginia	Covers (with prior auth)
Wisconsin	Covers (with prior auth)
Kansas	Covers, heavy restrictions
Massachusetts	Covers, heavy restrictions
Michigan	Covers, heavy restrictions

North Carolina temporarily dropped coverage in October 2025 and reinstated it in December 2025 — its current status above reflects January 2026.

States that dropped coverage in 2026

State	Status
California	Dropped Jan 2026 (budget)
New Hampshire	Dropped Jan 2026 (budget)
Pennsylvania	Dropped Jan 2026 (budget)
South Carolina	Dropped Jan 2026 (budget)

What to know before you assume either way

Even in covering states, expect prior authorization, BMI thresholds, and documentation of prior weight-loss attempts.
Managed-care plans within a state can differ from the fee-for-service policy listed here.
The CMS BALANCE Model is a voluntary federal program that could let more state Medicaid agencies add coverage at negotiated prices, with applications open through July 2026 and coverage potentially starting in 2027.
Compounded semaglutide/tirzepatide is not covered by Medicaid in any state — it's cash-pay only.

State not covering it, or you're on managed care?

See cash-pay and telehealth options that don't depend on your state Medicaid policy.

See Cash-Pay Options →

Source: KFF, "Medicaid Coverage of and Spending on GLP-1s", January 2026 fee-for-service survey. Coverage changes quarterly — confirm current status with your state Medicaid office before relying on this page.