Effective October 1ST, 2025, NC Medicaid coverage for GLP-1s for the treatment of obesity will be discontinued.
According to the NC Medicaid Division of Health Benefits, certain weight loss medications will be discontinued due to insufficient program funding. Those medications include Wegovy, Zepbound and Saxenda. For those receiving Wegovy and Zepbound, providers will need to obtain a prior authorization for medication to be covered, but Saxenda will no longer be covered for any indications.
Coverage Remains Available for Additional Approved Uses
Wegovy
- To lower the risk of cardiovascular death, heart attack, and stroke in adults with obesity and cardiovascular disease.
- For treating noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH), previously called nonalcoholic steatohepatitis (NASH), with moderate to advanced liver fibrosis (stages F2 to F3) in adults.
Zepbound
- For treating moderate to severe obstructive sleep apnea (OSA) in adults with obesity.
Other GLP-1 drugs such as diethylpropion, phendimetrazine and phentermine will continue to be managed through the Preferred Drug List (PDL) and do not require prior approval.
Coverage for GLP-1 medications used to treat diabetes will remain unchanged. Weight Management medications (Non-Incretin Mimetics) will also continue to be covered as specified on the PDL.
Advance Community Health is here for you and all your healthcare concerns. Our dedicated team of board-certified providers is committed to delivering compassionate, high-quality care to meet your individual and family health needs. Call today to schedule your appointment at 919-833-3111 and don’t hesitate to reach out to our pharmacists with any medication questions.
