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Medicaid coverage

Pennsylvania: what Medicaid covers

Pennsylvania ended coverage of GLP-1s for overweight and obesity on January 1, 2026, and added the class to the statewide preferred drug list. Obesity treatments that are not GLP-1s stay covered.

Checked against the primary source August 25, 2026
What Medicaid in Pennsylvania covers, and the criteria that apply.
Drug Position Criteria
Semaglutide Other indications only Not covered for overweight or obesity. Other indications keep coverage with prior authorization Changed January 1, 2026
Tirzepatide Other indications only Not covered for overweight or obesity. Other indications keep coverage with prior authorization Changed January 1, 2026
Liraglutide Not covered Saxenda is no longer covered for any indication Changed January 1, 2026
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. 1
    Medical Assistance Bulletin: Coverage Change and Prior Authorization of GLP-1 Receptor Agonists

    Pennsylvania Department of Human Services, Office of Medical Assistance Programs Primary text read and checked Checked August 25, 2026