Medicaid coverage
Does Florida Medicaid cover Wegovy?
Wegovy (semaglutide) for weight loss / obesity — the Florida Medicaid prior-authorization rule, source-cited.
Florida Medicaid Wegovy PA criteria
Weight loss is not a covered Florida Medicaid benefit - the anti-obesity GLP-1s (Wegovy, Saxenda, Zepbound) are absent from the GLP-1 criteria document and there is no weight-loss PA pathway (no BMI threshold, comorbidity, lifestyle-program, or step-therapy criteria).
Florida is not among the states covering GLP-1s for obesity under Medicaid.
The exclusion is uniform across FFS and the ~20 Statewide Medicaid Managed Care (SMMC) plans, which by statute (s. 409.91195) must implement the state-mandated single PDL and state PA criteria and cannot substitute their own UM.
Source: AHCA Florida Medicaid GLP-1 Receptor Agonist and Related Agents PA Criteria (rev. 03/12/2026). View cited GLP-1 policy reference →
Note: semaglutide is also sold as Ozempic for type 2 diabetes, which Florida Medicaid evaluates under a separate type 2 diabetes policy (not this one) — see does Florida Medicaid cover Ozempic?. Coverage follows the brand's FDA indication, not the molecule.
Frequently asked
- Does Florida Medicaid cover Wegovy for weight loss / obesity?
- Typically not covered. Weight loss is not a covered Florida Medicaid benefit - the anti-obesity GLP-1s (Wegovy, Saxenda, Zepbound) are absent from the GLP-1 criteria document and there is no weight-loss PA pathway (no BMI threshold, comorbidity, lifestyle-program, or step-therapy criteria). See the full source-cited criteria above. Per AHCA Florida Medicaid GLP-1 Receptor Agonist and Related Agents PA Criteria (rev. 03/12/2026), as of 2026-03-12 (orig. eff. 10/1/2025, rev. 3/12/2026) — confirm the member's current plan policy.
d3rx does not hold plan-specific pharmacy formularies or PBM prior-auth grids, so it cannot confirm a particular plan's GLP-1 coverage, tier, or PA criteria. The guidance below is the general, source-cited rule; confirm the specific plan's pharmacy formulary / PA policy for a binding answer.
Check Wegovy for another payer — or draft the PA
Run Wegovy + any payer in the GLP-1 PA lookup, or have Ask D3 draft a Florida Medicaid-ready prior-authorization request with the right criteria and codes — free, no signup.