Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1.
Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications.
The state will still consider prior authorization requests for Wegovy when prescribed for noncirrhotic metabolic dysfunction-associated steatohepatitis or cardiovascular disease, and for Zepbound when prescribed for obstructive sleep apnea.
Seven other GLP-1 drugs will remain on the formulary but only for type 2 diabetes: Ozempic, Rybelsus, Mounjaro, Victoza, Byetta, Bydureon and Trulicity.
Prior authorization requests for weight loss will be reviewed for medical necessity for beneficiaries younger than 21.
Sixteen state Medicaid programs, including California, covered GLP-1s when prescribed for the treatment of obesity as of October 1, 2025, according to KFF.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
