Does Molina Healthcare cover GLP-1s?
What Molina Healthcare says on its own pages (molinahealthcare.com), sorted by topic. Your own plan documents decide what you get.
Read Sep 28, 2026. Each line names the plan type it applies to.
Does it cover GLP-1s for weight loss?
- Molina Healthcare of Illinois (Medicaid) member drug page: some drugs are never covered by the plan.Medicaid (IL):
Some drugs are never covered by your plan. For example:
molinahealthcare.com, Sep 30, 2026 - Drugs for weight loss are on that never-covered list, unless other rules apply.Medicaid (IL):
Drugs for weight loss (unless other rules apply).
molinahealthcare.com, Sep 30, 2026
Prior authorization criteria
- Molina’s Texas provider pharmacy page, Marketplace section, lists a Wegovy policy titled with “NC” (the page does not define NC; the policy itself is a PDF).Individual (ACA) plans:
Wegovy (semaglutide) NC C27682-A
molinahealthcare.com, Sep 30, 2026 - The same Marketplace section lists a Zepbound policy titled with “NC” (not defined on the page; the policy is a PDF).Individual (ACA) plans:
Zepbound (tirzepatide) NC C29112-A
molinahealthcare.com, Sep 30, 2026
How to check your own plan
- Molina Illinois Medicaid offers a preferred drug list search tool (lead-in to a list: search by name/class, find generics, see limits and PA).Medicaid (IL):
Use our preferred drug list search tool to:
molinahealthcare.com, Sep 30, 2026 - The Illinois PDL search tool shows whether a medicine has quantity limits, age limits, or requires prior authorization.Medicaid (IL):
See if your medicine has quantity limits, has age limits, or requires Prior Authorization.
molinahealthcare.com, Sep 30, 2026 - Molina Medicare’s Texas drug page gives the Pharmacy Call Center number, (800) 665-3086 (TTY 711).Medicare:
If you need help, call the Pharmacy Call Center at (800) 665-3086 (TTY: 711).
molinahealthcare.com, Sep 30, 2026
What we could not confirm
- No web page from Molina Healthcare that we could read covers: does it depend on your employer or plan; sleep apnea (zepbound); heart risk (wegovy); type 2 diabetes; recent changes.
- More detail, such as exact BMI cutoffs, is in 7 PDF documents from Molina Healthcare, which we have not opened.
Next steps
- Prior authorization and appeal letter templates
- Can you use the maker's savings card with your coverage?
- If it is not covered: the lowest verified cash prices
Other insurers: Aetna, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Illinois, Blue Shield of California, Cigna, Florida Blue, Highmark, Humana, Independence Blue Cross, Kaiser Permanente, Oscar Health, Premera Blue Cross, UnitedHealthcare, Ambetter, Wellcare, TRICARE, FEP Blue (federal employees), BlueCross BlueShield of South Carolina, CareFirst BlueCross BlueShield