Does Vermont Medicaid cover Ozempic or Wegovy or Rybelsus for weight loss?

Other indications only. Wegovy injection is preferred under "Cardiometabolic Health Agents", for cardiovascular event reduction at a BMI over 27 with a prior stroke, heart attack or peripheral arterial disease, or for MASH. The authorization requires that it is not being used for weight loss only, and that the patient does not have diabetes

Does Vermont Medicaid cover Mounjaro or Zepbound for weight loss?

Other indications only. Zepbound is preferred under a class titled "Obstructive Sleep Apnea": a sleep study showing more than 15 events an hour, a BMI over 30, CPAP already prescribed, and no type 2 diabetes. Renewal needs documented weight loss over 5%

Does Vermont Medicaid cover Saxenda or Victoza for weight loss?

Other indications only. Saxenda is not on the list. Victoza and generic liraglutide are, in the diabetes class, so the molecule is covered and the weight-loss brand is not listed

Medicaid coverage

Vermont: what Medicaid covers

Vermont excludes the use rather than the drugs, and says so in its own preamble: drugs used for weight loss are excluded from coverage. It then pays for Wegovy for cardiovascular risk and MASH, and for Zepbound for obstructive sleep apnea. The prior-authorization criteria for Wegovy require that the medication is not being used for weight loss only, which is the clearest statement of this distinction anywhere on this page.

Checked against the primary source August 26, 2026

What Medicaid in Vermont covers, and the criteria that apply.
Drug	Position	Criteria
Semaglutide	Other indications only	Wegovy injection is preferred under "Cardiometabolic Health Agents", for cardiovascular event reduction at a BMI over 27 with a prior stroke, heart attack or peripheral arterial disease, or for MASH. The authorization requires that it is not being used for weight loss only, and that the patient does not have diabetes
Tirzepatide	Other indications only	Zepbound is preferred under a class titled "Obstructive Sleep Apnea": a sleep study showing more than 15 events an hour, a BMI over 30, CPAP already prescribed, and no type 2 diabetes. Renewal needs documented weight loss over 5%
Liraglutide	Other indications only	Saxenda is not on the list. Victoza and generic liraglutide are, in the diabetes class, so the molecule is covered and the weight-loss brand is not listed

Semaglutide Other indications only

Wegovy injection is preferred under "Cardiometabolic Health Agents", for cardiovascular event reduction at a BMI over 27 with a prior stroke, heart attack or peripheral arterial disease, or for MASH. The authorization requires that it is not being used for weight loss only, and that the patient does not have diabetes
Tirzepatide Other indications only

Zepbound is preferred under a class titled "Obstructive Sleep Apnea": a sleep study showing more than 15 events an hour, a BMI over 30, CPAP already prescribed, and no type 2 diabetes. Renewal needs documented weight loss over 5%
Liraglutide Other indications only

Saxenda is not on the list. Victoza and generic liraglutide are, in the diabetes class, so the molecule is covered and the weight-loss brand is not listed

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
Vermont Medicaid Preferred Drug List and Clinical Criteria, effective August 1, 2026
Vermont Department of Vermont Health Access Primary text read and checked Checked August 26, 2026