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Does DC Medicaid cover GLP-1s for weight loss?
Not covered for weight loss
DC Medicaid did not cover GLP-1s for weight loss as of January 2026, according to KFF, though it must cover them for type 2 diabetes.
Weight loss
Not covered, January 2026
Type 2 diabetes
Required in every state
Heart risk, sleep apnea
Required (Wegovy, Zepbound)
Prior authorization
Typical when covered
Federal law lets each state decide whether Medicaid pays for drugs used for weight loss, while drugs approved for diabetes must be covered. KFF counts coverage under fee-for-service; if your DC Medicaid coverage comes through a managed care plan, its formulary can differ, so ask the plan before you fill.
What may have changed since January
CMS’s BALANCE model lets state Medicaid programs add GLP-1s for weight management at a negotiated price. States could join on a rolling basis from May 1, 2026 through January 1, 2027, and the state application deadline was July 31, 2026. We could not find a published list of the states that joined, so this page does not say whether DC Medicaid did. Ask your plan. Either way your cost stays at Medicaid’s nominal copay, which BALANCE does not change.
The national picture, coupons and patient assistance: does Medicaid cover GLP-1s.
How many GLP-1s does DC Medicaid pay for?
27,754 GLP-1 prescriptions in 2025, 44th of the 50 states and DC, with $22.0 million reimbursed before rebates.
Prescriptions, 2025
27,754
44th of 51
Medicaid paid
$22.0M
43rd of 51, before rebates
Per prescription
$794
$1,051 nationally
Weight-loss brands
1.9%
34th highest share of 51
Wegovy, Zepbound and Saxenda, the brands approved for weight management, were 1.9% of DC Medicaid's GLP-1 prescriptions in 2025 (538). Across the 13 states KFF lists as covering GLP-1s for obesity, the median share was 52%; across the other 38, 2.3%. Where weight loss is not covered, those brands are mostly filled for the uses Medicaid must cover, such as heart risk and sleep apnea.
| Brand | Prescriptions | Share | Medicaid paid |
|---|---|---|---|
| Ozempic | 15,986 | 58% | $13.0 million |
| Mounjaro | 5,681 | 20% | $4.8 million |
| Trulicity | 5,232 | 19% | $3.8 million |
| Zepboundapproved for weight management | 358 | 1.3% | $240,849 |
| Rybelsus | 303 | 1.1% | $116,802 |
| Wegovyapproved for weight management | 180 | 0.6% | $130,694 |
Source: CMS State Drug Utilization Data 2025, updated Jul 13, 2026, all four quarters, fee-for-service and managed care. Before rebates. CMS suppresses rows under 11 prescriptions, so small brands are undercounted slightly. Every state ranked: prescriptions and spending.
On Medicare in Washington, DC?
Medicare’s temporary GLP-1 Bridge works the same in every state: a $50 copay for a one-month supply of Wegovy, Foundayo or the Zepbound KwikPen, for people with Part D who meet its weight and health rules.
medicare.gov, read Oct 3, 2026: “You’ll pay a $50 copayment to the pharmacy for a one-month supply (either 28 or 30 days, depending on drug).”
Washington, DC and the states around it
Medicaid’s weight-loss answer (January 2026, KFF) and the partner programs that ship there, priced the same way as above.