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Insurance / Medicaid / Washington

Does Washington Medicaid cover GLP-1 drugs for weight loss?

Apple Health, from the state's own document. Weight-loss use only.

Short answer

Not covered for weight loss aloneIn effect from Feb 1, 2026

Since February 1, 2026, Apple Health does not cover Wegovy for weight loss.12

Source: HCA medical policy 61.25.20.AA-4, effective 2/1/2026 · checked Oct 17, 2026

What the state's document says

Word for word from the document, as archived on Oct 17, 2026.

“Semaglutide injection or tablet (Wegovy®) is not covered by Apple Health for weight loss”
Washington Apple Health: HCA medical policy 61.25.20.AA-4, effective 2/1/2026 · as of Oct 17, 2026
“Effective Date: 2/1/2026”
Washington Apple Health: HCA medical policy 61.25.20.AA-4, effective 2/1/2026 · as of Oct 17, 2026

Federal background

Self-pay prices and government insurance

The makers list self-pay prices for each strength; see every self-pay price, cheapest first. The official wording about government insurance differs between pages; read the offer terms before relying on a self-pay price.89

Next step

Ask Apple Health or your Medicaid plan whether a specific drug is covered for you. The document above is what we checked; your plan may have newer rules.

Which drug, which dose, and whether to start, stop or switch are medical decisions. Ask your doctor or pharmacist.

Other states we have checked

See the map of all states

Official sources for this page (9)
  1. “Semaglutide injection or tablet (Wegovy®) is not covered by Apple Health for weight loss”
  2. “Effective Date: 2/1/2026”
  3. “Each state runs its own Medicaid program according to certain federal guidelines.”
    NovoCare: Medicaid · as of Oct 17, 2026
  4. “As a result, Medicaid eligibility and benefits can vary widely from state to state.”
    NovoCare: Medicaid · as of Oct 17, 2026
  5. “As part of this voluntary model, CMS will negotiate drug pricing and coverage terms with manufacturers of GLP-1 medications on behalf of state Medicaid agencies and Medicare Part D plan sponsors.”
  6. “States may choose to start participating in BALANCE starting on a date of their choosing between May 1, 2026, and January 1, 2027.”
    CMS HPMS memo, April 21, 2026 · as of Oct 17, 2026
  7. “States that do not join the model by January 1, 2027, will not be allowed to participate in the model except at CMS discretion.”
    CMS HPMS memo, April 21, 2026 · as of Oct 17, 2026
  8. “Self-pay pricing varies by dose. Eligibility and restrictions apply. Government beneficiaries excluded. One month is defined as one bottle containing 30 tablets. Novo Nordisk reserves the right to modify or cancel this offer at any time. See full Terms and Conditions.”
  9. “Patients who use this savings offer and are enrolled in government, state, or federally-funded medical or prescription benefit programs are able to pay the self-pay price for their prescription. This offer operates outside of any third-party insurance. The money spent and discounts on your prescription will not count toward your deductible or out-of-pocket requirements and cannot be submitted for reimbursement to your insurer.”
    NovoCare: Wegovy savings offer · as of Oct 17, 2026