Does North Carolina Medicaid cover Ozempic or Wegovy or Rybelsus for weight loss?

Covered, prior authorization. Wegovy is the preferred product

Does North Carolina Medicaid cover Mounjaro or Zepbound for weight loss?

Covered, prior authorization. Non-preferred. Requires a trial and failure of Wegovy first

Does North Carolina Medicaid cover Saxenda or Victoza for weight loss?

Covered, prior authorization. Non-preferred. Requires a trial and failure of Wegovy first

Medicaid coverage

North Carolina: what Medicaid covers

North Carolina stopped covering GLP-1s for obesity on October 1, 2025 and reinstated coverage on December 12, 2025, back to the criteria that applied on September 30, 2025.

Checked against the primary source August 25, 2026

What Medicaid in North Carolina covers, and the criteria that apply.
Drug	Position	Criteria
Semaglutide	Prior authorization	Wegovy is the preferred product Changed December 12, 2025
Tirzepatide	Prior authorization	Non-preferred. Requires a trial and failure of Wegovy first Changed December 12, 2025
Liraglutide	Prior authorization	Non-preferred. Requires a trial and failure of Wegovy first Changed December 12, 2025

Semaglutide Prior authorization

Wegovy is the preferred product

Changed December 12, 2025
Tirzepatide Prior authorization

Non-preferred. Requires a trial and failure of Wegovy first

Changed December 12, 2025
Liraglutide Prior authorization

Non-preferred. Requires a trial and failure of Wegovy first

Changed December 12, 2025

If the answer is no. Around 45% of initial prior authorizations for these drugs are refused, and 35 to 45% of first-level appeals are overturned. A refusal is not the end of the process, and the cash-pay routes are priced on this site alongside it.

Sources

Every claim above is checked against the primary text, and the date is the day we last opened it.

1
NC Medicaid to Reinstitute Coverage of GLP-1s for Weight Management
North Carolina Department of Health and Human Services, Division of Health Benefits Primary text read and checked Checked August 25, 2026