Last updated: July 2026. This tracks Medicaid coverage of GLP-1s for obesity / weight loss under fee-for-service. Coverage for GLP-1s used for type 2 diabetes or cardiovascular risk is far more widely available and works differently. Rules change often and nearly always require prior authorization — always confirm with your own state Medicaid program. Based on KFF data and public state trackers. Spot a change? Tell us.
States that cover weight-loss GLP-1s
As of early 2026, per KFF and public trackers. "Restricted" means coverage exists but with extra criteria (e.g. higher BMI thresholds or step requirements).
| State | Obesity coverage | Notes |
|---|---|---|
| Delaware | Yes | Fee-for-service |
| Minnesota | Yes | Fee-for-service |
| Mississippi | Yes | Fee-for-service |
| Missouri | Yes | Fee-for-service |
| North Carolina | Yes | Cut Oct 2025, reinstated Dec 2025 |
| Rhode Island | Yes | Fee-for-service |
| Tennessee | Yes | Fee-for-service |
| Utah | Yes | Fee-for-service |
| Virginia | Yes | Fee-for-service |
| Wisconsin | Yes | Fee-for-service |
| Kansas | Restricted | Severe-obesity / CVD pathway |
| Massachusetts | Restricted | BMI criteria; narrowing from July 1, 2026 |
| Michigan | Restricted | Morbid obesity; prior interventions required |
Every other state's Medicaid does not currently cover GLP-1s for obesity under fee-for-service (managed-care plans can occasionally differ). This list changes — verify with your state before relying on it.
What just changed
| Change | States | When |
|---|---|---|
| Dropped obesity coverage | California, New Hampshire, Pennsylvania, South Carolina | Effective Jan 1, 2026 |
| Reinstated after a cut | North Carolina | Dec 2025 (cut in Oct 2025) |
| Narrowing criteria | Massachusetts | From July 1, 2026 |
How Medicaid GLP-1 coverage actually works
- Obesity coverage is optional. Federal rules let states choose whether Medicaid covers weight-loss drugs, so it varies state to state — and the trend in 2025–2026 has been fewer states covering, driven by cost.
- Diabetes and heart-risk coverage is different. When a GLP-1 is prescribed for type 2 diabetes or cardiovascular risk (its approved medical uses), Medicaid coverage is far more common everywhere.
- Prior authorization is the norm. Even in covering states, expect BMI thresholds, documentation and step requirements.
- The BALANCE Model may expand access. A voluntary CMS demonstration began rolling out for Medicaid in 2026; states can opt in, which could add coverage over time.
How we track this
We compile this from KFF's Medicaid GLP-1 coverage research and public state trackers, and we re-check it as states change their formularies. Because coverage is set by each state and shifts often, treat this as a current snapshot — the definitive answer for you is always your own state Medicaid program or your prescriber's office. For the bigger picture on paying for a GLP-1, see our cost & insurance guide and the live price tracker.
Sources
- KFF — Medicaid Coverage of and Spending on GLP-1s (survey of state Medicaid programs).
- Public state Medicaid GLP-1 coverage trackers (fee-for-service).
- Stateline — reporting on states dropping GLP-1 obesity coverage.
- CMS — BALANCE Model for Medicaid.