Medicaid coverage

Louisiana: what Medicaid covers

Louisiana is the opposite shape to most of this grid. It does not exclude these drugs: Wegovy and Zepbound are both on its preferred drug list, each carrying point-of-sale requirements and each needing a signed patient treatment agreement, which is the machinery a state builds when it intends to pay for something and control it. What the list does not do is name the indication, and the words weight and obesity do not appear anywhere in it. Zepbound additionally carries a diagnosis-code requirement, and a diagnosis code is exactly where an apnea-only restriction would be hidden. So the criteria document is the thing that would settle this, and Louisiana does not publish one we could reach. Both cells are therefore marked not checked rather than covered: the drugs are on the list, and whether that list pays for weight loss is the part we could not read.

• Semaglutide not checked

  Wegovy is on the point-of-sale requirements list, needing additional clinical information, a quantity limit and a signed patient treatment agreement. The list does not say which indication the criteria are for

• Tirzepatide not checked

  Zepbound is on the point-of-sale requirements list, needing a diagnosis code, an age limit, a quantity limit and a signed patient treatment agreement. The list does not say which diagnosis

• Liraglutide not checked

  Saxenda is not named anywhere on the preferred drug list