Alaska Medicaid does not cover Wegovy or Zepbound for weight loss

Alaska Medicaid does not cover Wegovy, Wegovy tablets or Zepbound for weight loss: its criteria deny any of them prescribed for weight control, citing Alaska regulations 7 AAC 105.110 and 7 AAC 120.112. It covers Wegovy only for listed cardiovascular conditions or MASH, and Zepbound only for moderate to severe obstructive sleep apnea, with prior authorization.1234

Alaska Medicaid publishes clinical criteria for semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), both updated Sept. 18, 2026. First approvals last up to 3 months and renewals up to 12 months.1234

• Wegovy injection and Wegovy tablets: FDA-labeled age, a BMI of 25 or more, and a documented diagnosis of one of: prior heart attack, prior ischemic or hemorrhagic stroke, chronic ischemic heart disease, peripheral artery disease, atherosclerosis, or (Wegovy injection only) MASH with stage F2 to F3 liver fibrosis.
• Zepbound: FDA-labeled age, a BMI of 30 or more, and moderate to severe obstructive sleep apnea (an apnea-hypopnea index over 15 events per hour) confirmed by a documented sleep study.
• Ozempic injection and tablets: type 2 diabetes with an A1C over 7% in the last 60 days, ASCVD, or chronic kidney disease (or a qualifying diagnosis code on the claim), a current diabetes care plan, and a 3-month metformin trial unless contraindicated.
• Mounjaro: type 2 diabetes with an A1C over 7% in the last 60 days or ASCVD, a current diabetes care plan, a 3-month metformin trial, and 3-month trials of two preferred GLP-1 drugs.
• For every drug, the prescriber attests that dose escalation will not be pursued solely for more weight loss once the covered condition is controlled.
• Denied when prescribed for weight control, with another GLP-1 or GIP drug, or with a history of medullary thyroid cancer, MEN 2 or severe gastroparesis. Quantity limit: four pens a month (or 34 tablets per 34 days for semaglutide tablets).

Coverage for other uses the FDA has approved:

• Wegovy (injection), reduction of the risk of major cardiovascular events in adults with a BMI of 25 or more and a documented heart attack, stroke, chronic ischemic heart disease, peripheral artery disease or atherosclerosis (injection and tablets): Covered with prior authorization1
• Wegovy (injection), MASH with stage F2 to F3 liver fibrosis (injection only): Covered with prior authorization1
• Zepbound, moderate to severe obstructive sleep apnea with a BMI of 30 or more, confirmed by a sleep study: Covered with prior authorization3

What changed, and when:

CMS BALANCE model: CMS's BALANCE model page names no participating states, and we found no Alaska Medicaid announcement that Alaska has joined.9

Since Jan. 1, 2026, the AlaskaCare Employee Health Plan fills weight-loss GLP-1 prescriptions (Wegovy, Zepbound, Foundayo, Saxenda and generic liraglutide) only through a program run by Virta Health with Optum Rx, for members who meet the FDA clinical criteria. The prescription must come from a Virta Health provider after a virtual consult.1011

Pharmacy benefit: Optum Rx (pharmacy), with Virta Health for weight-loss GLP-1s; Aetna (medical).

Marketplace (ACA) plans: Alaska's essential health benefits benchmark plan for 2026 to 2028, a Premera Blue Cross Blue Shield of Alaska small-group plan, excludes all obesity drugs.1415

On the preferred drug list effective Nov. 1, 2026, Ozempic (pens and tablets), Rybelsus, Trulicity and Victoza are preferred, and Mounjaro is non-preferred. Ozempic and Mounjaro also have their own prior authorization criteria; Mounjaro needs trials of two preferred GLP-1 drugs first.5613

In 2025, Alaska Medicaid paid for 22,851 GLP-1 prescriptions, $21.9 million before rebates: 31 per 1,000 residents, against 32 across the states and DC, 18th of 51.62 It reimbursed 6 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 68 rows count as zero here and the totals are a floor.

Part D still excludes drugs used for weight loss alone: the Part D drug definition excludes drugs and uses Medicaid may exclude under SSA §1927(d)(2), which lists agents used for weight loss. Part D plans can cover GLP-1s for type 2 diabetes, MACE risk reduction (Wegovy), moderate-to-severe obstructive sleep apnea (Zepbound) and noncirrhotic MASH with fibrosis (Wegovy). For weight loss alone, the Medicare GLP-1 Bridge demonstration (July 1, 2026 – Dec 31, 2027) gives eligible Part D enrollees Foundayo, Wegovy or Zepbound KwikPen for a $50 monthly copay, outside the Part D benefit. The BALANCE Model's Part D component is not launching in 2027.3738282924321727

• Medicare GLP-1 Bridge (demonstration) (active, from 2026-07-01): Runs July 1, 2026 to December 31, 2027 (extended). Outside the Part D benefit: $50 copay per one-month supply (28 or 30 days), Part D deductible does not apply, the copay does not count toward TrOOP, no low-income subsidy. Covers Foundayo, Wegovy (injection or tablet) and Zepbound KwikPen only (not Zepbound single-dose vials or pens). Eligibility: age 18+ and, when starting GLP-1 therapy, BMI ≥35; or BMI ≥30 with heart failure with preserved ejection fraction, uncontrolled hypertension, or CKD stage 3a+; or BMI ≥27 with prediabetes, prior heart attack or stroke, or symptomatic peripheral artery disease. People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible (their Part D plan may cover GLP-1s for those conditions). Prior authorization required; valid through Dec 31, 2027 unless the patient changes GLP-1s.2425261732333435363130
• BALANCE Model — Medicare Part D component (not launching in 2027; future implementation described by CMS only as 'potential'): Originally announced to launch in Part D in January 2027. CMS's BALANCE page FAQ now refers to 'the BALANCE Model not launching in Medicare in 2027' and extends the Bridge through Dec 31, 2027 to collect data 'ahead of potential implementation of BALANCE in Part D'. No new start date is published.192117

In 2024, Medicare Part D drug plans paid for 33,832 GLP-1 claims from prescribers in Alaska, $44.3 million in total drug cost.63

The lowest price among the programs that ship to every state is WellMedr: $492 for 12 months ($41 a month); $99 month to month, fees in.67 Includes a sale seen on November 5, 2026; the price returns to the standing price when it ends. The cheapest programs, ranked, or every program, ranked on our score.

Prices are what each program charged at its own checkout, fees in, with the total due for the plan length first. Compounded GLP-1s are prepared by a pharmacy to a prescription, and they are not FDA-approved; the section on compounding explains what that means.

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29 more programs we rank ship to fewer than 50 states, or don’t say how many. We don’t record which states they leave out, so check Alaska on their sites: Embody, Collective, SnagRx, Enhanced, Direct Meds, Gala Health, GobyMeds, CoreAge Rx, Maximus Tribe, Brightmeds, SkinnyRx, Willow, Strut Health, Enhance MD, LumiMeds, VivioMD, MEDGm, MyDrHank, Zevay, LevelsRx, Hume Care, ReadyRx, Hers, Luvo Health, Remedy Meds, Hims, DudeMeds, G-Plans and Found.

The makers also sell some brand-name GLP-1s for cash, at the same price in every state, with a prescription:

These are standing prices. The Zepbound and Wegovy rankings list each dose and the terms of each offer.

Compounded GLP-1s are prepared by a pharmacy to a prescription. They are not FDA-approved: the FDA doesn’t review their safety, effectiveness or quality before they’re sold, and they are not the same as Wegovy or Zepbound. Formulas can differ from one pharmacy to the next, and some add ingredients such as vitamin B12.6869 Compounding pharmacies are licensed and inspected by state boards of pharmacy; outsourcing facilities (503B) also register with the FDA and are inspected by it. The FDA can issue warning letters when either breaks rules on safety or sterility.

We found no action on compounded GLP-1s by Alaska’s board of pharmacy or attorney general on their own sites.

The FDA’s register lists 0 outsourcing facilities (503B) in Alaska, as of November 6, 2026.64