This was a deliberate state budget change, not a paperwork glitch. If you were on a GLP-1 for weight loss and your pharmacy suddenly stopped covering it at the start of 2026, this is why. Here's exactly what changed, what's still covered, and what your options are.
Medi-Cal Rx removed the anti-obesity GLP-1 drugs from its covered list when prescribed for weight loss only:
Any PA that had previously approved one of these drugs for weight loss expired on December 31, 2025. Medi-Cal Rx also stopped approving new PAs for weight-loss-only use.
Seven GLP-1 drugs remain on the formulary, but only for type 2 diabetes. They stay covered as long as your prescriber submits the diabetes diagnosis code with the prescription:
Note the split: the same molecule can be covered or not depending on the brand and the reason. Semaglutide as Ozempic (a diabetes drug) is covered for diabetes; semaglutide as Wegovy (the obesity brand) is not covered for weight loss.
A few conditions other than diabetes still open a path, because they aren't weight-loss indications:
| Situation | Drug | Medi-Cal coverage |
|---|---|---|
| Noncirrhotic MASH (a serious liver disease) | Wegovy | Covered — and as of April 1, 2026 does not require a PA when the diagnosis code is submitted |
| Cardiovascular disease | Wegovy | Covered with an approved PA |
| Obstructive sleep apnea (OSA) | Zepbound | Covered with an approved PA |
| Member under 21 who needs it for weight | GLP-1 drugs | Covered case-by-case with an approved PA, under the federal EPSDT benefit for children |
Tell us your plan, drug and reason, and see whether you're likely covered — plus exactly what to document or how to appeal.
Check my coverageYes — for type 2 diabetes. Ozempic stays on the Medi-Cal Rx formulary and is covered when your prescriber submits a type 2 diabetes diagnosis code with the prescription. It is not covered when prescribed purely for weight loss.
No, not as of January 1, 2026. Wegovy was removed from the Medi-Cal Rx Contract Drugs List for weight-loss use, and previously approved prior authorizations ended December 31, 2025. Wegovy can still be covered for noncirrhotic MASH (no PA needed as of April 1, 2026) or, with a PA, for cardiovascular disease.
Not for weight loss — Zepbound was dropped for the weight-loss indication on January 1, 2026. It can still be covered with an approved prior authorization when prescribed for obstructive sleep apnea (OSA).
It was a California state budget decision. Effective January 1, 2026, Medi-Cal Rx removed Wegovy, Zepbound and Saxenda from its covered drug list for weight loss to control spending on these medications. Coverage continues for type 2 diabetes and for the specific non-obesity conditions noted above.
Yes. If you received a Notice of Action denying coverage, you generally have 90 days to request a State Hearing from the California Department of Social Services (1-800-743-8525). If you were taking the drug on or before January 1, 2026 and request the hearing within 10 days of the notice, you may be able to keep receiving it while the hearing is pending.
Yes. For members under 21, Medi-Cal can still cover a GLP-1 for weight on a case-by-case basis with an approved prior authorization, under the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit for children.
Related: Weight-loss coverage — the full guide · Does Medicare cover Wegovy? · Texas Medicaid · Florida Medicaid · GLP-1 coverage by insurer