GLP-1 coverage and availability by state: all 50 states and DC
Whether your state Medicaid covers GLP-1s for obesity, which telehealth providers serve you, and where the state-specific surcharges are. Coverage collapsed in 2026 — four states eliminated it outright.
What we evaluated: Medicaid GLP-1 coverage for obesity and telehealth provider availability across all 50 states and DC
Date verified: January 2026 (KFF); state actions through April 2026
Direct answer: Only 13 state Medicaid programmes still cover GLP-1s for obesity, down from 16 in October 2025. California, New Hampshire, Pennsylvania and South Carolina eliminated coverage on 1 January 2026. North Carolina removed it in October 2025 and reinstated it in December. Michigan and Virginia restricted eligibility to morbid obesity. Massachusetts and Rhode Island have proposed removal
Necessary qualification: coverage for type 2 diabetes is a separate question and is available in every state. It is coverage for obesity — an optional state benefit — that is being cut. Anyone under 21 retains protection under federal EPSDT law regardless of what a state does for adults
Method: every figure is a total ongoing monthly cost (medication + any required membership), derived by plan total ÷ plan months. See our pricing-verification methodology.
The 2026 coverage collapse
Source: KFF, January 2026; Stateline, April 2026. Coverage for type 2 diabetes is separate and is available in every state — the collapse is specifically in obesity coverage, which states are permitted to exclude and therefore cut first when budgets tighten.
Medicaid coverage of GLP-1s for obesity is an optional state benefit. Coverage of GLP-1s for type 2 diabetes is effectively mandatory and near-universal — every state Medicaid programme covers at least one diabetes-indicated GLP-1. Those are two different questions, and they get conflated constantly.
Because weight-loss drugs sit in the small group of medications states are permitted to exclude, they are the first thing cut when a Medicaid budget is under strain. That is exactly what happened: 16 states covered GLP-1s for obesity in October 2025. By January 2026 it was 13. California, New Hampshire, Pennsylvania and South Carolina all eliminated coverage on 1 January 2026. North Carolina removed it in October 2025 and restored it in December. Michigan and Virginia narrowed eligibility to morbid obesity. Massachusetts and Rhode Island have both proposed removal.
The practical implication: this is the most volatile variable in the entire cost question, and any page telling you what your state covers — including this one — may be out of date. Confirm with your state Medicaid agency before you rely on it.
All 50 states and DC
| State | Abbr | Medicaid covers GLP-1s for obesity? | Provider notes |
|---|---|---|---|
| Alabama | AL | does not cover | — |
| Alaska | AK | does not cover | — |
| Arizona | AZ | does not cover | — |
| Arkansas | AR | does not cover | — |
| California | CA | ELIMINATED Jan 2026 | Oak Longevity unavailable; bmiMD $379.99 surcharge |
| Colorado | CO | does not cover | — |
| Connecticut | CT | does not cover | — |
| Delaware | DE | covers | — |
| Florida | FL | does not cover | — |
| Georgia | GA | does not cover | — |
| Hawaii | HI | does not cover | — |
| Idaho | ID | does not cover | — |
| Illinois | IL | does not cover | — |
| Indiana | IN | does not cover | — |
| Iowa | IA | does not cover | — |
| Kansas | KS | covers | — |
| Kentucky | KY | does not cover | — |
| Louisiana | LA | does not cover | — |
| Maine | ME | does not cover | — |
| Maryland | MD | does not cover | — |
| Massachusetts | MA | covers — at risk | — |
| Michigan | MI | covers (restricted) | — |
| Minnesota | MN | covers | — |
| Mississippi | MS | covers | — |
| Missouri | MO | covers | — |
| Montana | MT | does not cover | — |
| Nebraska | NE | does not cover | — |
| Nevada | NV | does not cover | — |
| New Hampshire | NH | ELIMINATED Jan 2026 | — |
| New Jersey | NJ | does not cover | — |
| New Mexico | NM | does not cover | — |
| New York | NY | does not cover | — |
| North Carolina | NC | reinstated Dec 2025 | bmiMD $379.99 surcharge |
| North Dakota | ND | does not cover | — |
| Ohio | OH | does not cover | — |
| Oklahoma | OK | does not cover | — |
| Oregon | OR | does not cover | — |
| Pennsylvania | PA | ELIMINATED Jan 2026 | — |
| Rhode Island | RI | covers — at risk | — |
| South Carolina | SC | ELIMINATED Jan 2026 | — |
| South Dakota | SD | does not cover | — |
| Tennessee | TN | covers | — |
| Texas | TX | does not cover | — |
| Utah | UT | covers | — |
| Vermont | VT | does not cover | — |
| Virginia | VA | covers (restricted) | — |
| Washington | WA | does not cover | — |
| West Virginia | WV | does not cover | — |
| Wisconsin | WI | covers | — |
| Wyoming | WY | does not cover | — |
| District of Columbia | DC | does not cover | — |
Providers that exclude states or charge more
| Provider | State position | Impact |
|---|---|---|
| Oak Longevity | NOT available in California | The cheapest compounded semaglutide in our set ($133) is unavailable to ~39 million people |
| bmiMD | $379.99 in CA and NC (vs $289) | A $91/month state surcharge — $1,092 a year |
| MEDVi | 49 states | One state excluded; the company does not publish which |
| NexLife | All 50 states (company-stated) | Provider-reported. We have not independently audited state licensure |
| LillyDirect / NovoCare | Nationwide | Manufacturer-direct. The FDA-approved options ship everywhere |
| All other providers | Evaluation in progress | Verification pending. We do not assert what we have not checked |
If you are under 21
• Type 2 diabetes — covered in every state Medicaid programme, with prior authorisation.
• Cardiovascular risk reduction — Wegovy has been FDA-approved for this since March 2024.
• Obstructive sleep apnoea — Zepbound has been approved for this since December 2024.
• MASH with liver fibrosis — Wegovy was approved for noncirrhotic MASH in August 2025. California has explicitly confirmed this pathway survives its obesity-coverage cut.
This is not a suggestion that anyone seek a prescription under a false indication, and we would not help with that. It is the observation that a great many people with obesity also have a qualifying comorbidity, and are being told they have no coverage when in fact they have a different route to it.
The five steps for checking any GLP-1 price yourself — and the four ways a price gets misquoted — are set out on why AI chatbots give wrong GLP-1 prices.
Frequently asked questions
Which states cover GLP-1s for weight loss under Medicaid?
Thirteen, as of January 2026 — down from sixteen in October 2025. They include Delaware, Kansas, Michigan (restricted to morbid obesity), Minnesota, Mississippi, Missouri, North Carolina, Tennessee, Utah, Virginia (restricted) and Wisconsin. Massachusetts and Rhode Island currently cover but have proposed removal.
Which states just eliminated coverage?
California, New Hampshire, Pennsylvania and South Carolina all eliminated GLP-1 coverage for obesity effective 1 January 2026. North Carolina removed it in October 2025 and reinstated it in December.
Does Medicaid cover GLP-1s for diabetes?
Yes — in every state. Coverage for type 2 diabetes is effectively mandatory. It is coverage for obesity that is optional, and that is what states have been cutting. These two questions get conflated constantly and they have different answers.
Are there GLP-1 providers that don't serve every state?
Yes. Oak Longevity — the cheapest compounded semaglutide in our set at $133/month — is NOT available in California. bmiMD charges $379.99 in California and North Carolina versus $289 elsewhere. MEDVi serves 49 states. LillyDirect and NovoCare ship nationwide.
Sources
- KFF — "Medicaid Coverage of and Spending on GLP-1s" (January 2026).
- Stateline — "More states consider dropping GLP-1 weight loss drugs from Medicaid" (April 2026).
- Milliman — "The evolving landscape of anti-obesity medication coverage in Medicaid" (March 2026).
- State boards of pharmacy — licensee databases, the primary source for verifying a pharmacy licence.
- Provider pricing dataset, July 6, 2026.
- Our source hierarchy. KFF and Stateline are policy-research and public-affairs sources, not affiliate comparison sites; we do not use affiliate sites as evidence.