KanCare covers GLP‑1s for weight loss, with prior authorization

Since September 19, 2023, KanCare's anti-obesity medication coverage includes all rebate-eligible anti-obesity drugs. Zepbound has been a preferred drug since April 1, 2024, Wegovy since June 1, 2025, and Foundayo since November 1, 2026; Saxenda has needed a preferred drug list prior authorization since April 1, 2024. The GLP-1 weight-loss drugs need prior authorization under the state's anti-obesity criteria.1245789

KanCare requires prior authorization for Saxenda, Foundayo, Wegovy (including Wegovy HD) and Zepbound. Adults qualify with a BMI of 30 or more, or 27 or more with at least one weight-related condition, and a treatment plan that includes diet, physical activity and behavioral therapy. The stricter severe-obesity criteria (BMI of 40 or more) no longer apply to Zepbound (since April 1, 2024), Wegovy (since June 1, 2025) or Foundayo (since November 1, 2026).21

• Adults: BMI of 30 or more, or 27 or more with at least one weight-related condition
• Ages 12 to 17: BMI at or above the 95th percentile for age and sex
• A treatment plan with diet changes, physical activity and behavioral therapy
• The preferred drug first, unless non-preferred criteria are met

Coverage for other uses the FDA has approved:

• Wegovy (injection), adults with a BMI of 27 or more and established cardiovascular disease, without diabetes: Covered with prior authorization9

What changed, and when:

CMS BALANCE model: CMS's BALANCE model page names no participating states, and we found no KanCare announcement that Kansas has joined.13

The SEHP covers GLP-1s for weight management with prior authorization through Caremark. Since January 1, 2026, a member needs a BMI of 35 or more, and the drug must be on the SEHP preferred drug list: Wegovy is preferred, and Zepbound is non-preferred unless the member has tried a preferred drug or cannot use it for medical reasons.14

Pharmacy benefit: CVS Caremark.

Marketplace (ACA) plans: Kansas's essential health benefits benchmark plan, a Blue Cross and Blue Shield of Kansas small-group plan, excludes any drug or supply for the medical management and treatment of obesity.1920

We could not read the current KanCare preferred drug list. KMAP bulletins show that the Ozempic pen became a preferred drug on July 1, 2023, that Mounjaro has required a clinical prior authorization since March 18, 2023, and that Ozempic has required a clinical prior authorization since July 1, 2026.101112

In 2025, KanCare paid for 50,482 GLP-1 prescriptions, $53.3 million before rebates: 17 per 1,000 residents, against 32 across the states and DC, 37th of 51.68 It reimbursed 7 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 9 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 2027.4344343530382333

• 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.3031322338394041423736
• 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.252723

In 2024, Medicare Part D drug plans paid for 204,187 GLP-1 claims from prescribers in Kansas, $238.4 million in total drug cost.69

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.73 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 Kansas 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 B12.7475 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 Kansas’s board of pharmacy or attorney general on their own sites.

The FDA’s register lists 1 outsourcing facilities (503B) in Kansas, as of November 6, 2026; 0 show no inspection date and 1 were issued a Form 483.70