Minnesota Medical Assistance covers GLP‑1s for weight loss, with prior authorization

Minnesota Medical Assistance covers Wegovy, Zepbound, Saxenda and Foundayo for weight loss with prior authorization under its Anti-Obesity Medications criteria. On the uniform preferred drug list used by fee-for-service and managed care plans, Wegovy and Saxenda are preferred and Zepbound is nonpreferred.125911

Every weight management drug needs prior authorization. Requests for weight loss follow the Anti-Obesity Medications criteria; other approved uses follow the Weight Management Agents criteria.1345

• Patient meets the age limit on the drug's FDA label.
• Documentation of a reduced-calorie diet or ongoing care from a registered dietitian nutritionist, and of increased physical activity unless a condition rules it out.
• Baseline BMI of 30 or more (adults), 27 or more with at least one weight-related condition such as high blood pressure, type 2 diabetes or dyslipidemia (adults), or 30 or more with body weight above 60 kg (ages 12 to 17); baseline weight must be submitted.
• No other weight loss drug at the same time.
• First approval lasts 6 months for Wegovy and Saxenda. Renewal for 12 months needs at least 5% weight loss (adults) or a 5% drop in baseline BMI (ages 12 to 17), with diet and activity continuing; past 18 months the weight loss must be maintained.

Coverage for other uses the FDA has approved:

• Wegovy (injection), reduction of the risk of major adverse cardiovascular events in people with obesity or overweight and established cardiovascular disease, prescribed by or with a cardiologist: Covered with prior authorization6
• Wegovy (injection), noncirrhotic MASH with moderate to advanced liver fibrosis (F2 to F3), prescribed by or with a gastroenterologist or hepatologist: Covered with prior authorization7
• Zepbound, moderate to severe obstructive sleep apnea with obesity, prescribed by or with a sleep specialist, pulmonologist, ENT specialist or cardiologist: Covered with prior authorization8

What changed, and when:

CMS BALANCE model: CMS's BALANCE model page names no participating states, and we found no Minnesota Department of Human Services announcement that Minnesota has joined.18

CVS Caremark manages the prescription drug benefit of the Minnesota Advantage Health Plan for state employees. We found no public SEGIP document that states its GLP-1 weight-loss policy.19

Pharmacy benefit: CVS Caremark (prescription drug benefit); Blue Cross and HealthPartners (medical).

Marketplace (ACA) plans: Minnesota's essential health benefits benchmark plan is a HealthPartners small-group plan. Its benchmark documents list weight loss programs and bariatric surgery as not covered but say nothing about weight-loss drugs.22

On the uniform preferred drug list effective August 4, 2026, Ozempic, Trulicity and Victoza are preferred, and Mounjaro and Rybelsus are nonpreferred. In July 2026 the Drug Formulary Committee recommended moving Mounjaro to preferred; that change is not on the August 2026 list.1014

In 2025, Minnesota Medical Assistance paid for 224,149 GLP-1 prescriptions, $251.9 million before rebates: 38 per 1,000 residents, against 32 across the states and DC, 16th of 51.71 It reimbursed 8 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 21 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 2027.4647373833412636

• 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.3334352641424344454039
• 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.283026

In 2024, Medicare Part D drug plans paid for 307,550 GLP-1 claims from prescribers in Minnesota, $388.9 million in total drug cost.72

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.76 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 Minnesota 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 B12.7778 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.

The FDA’s register lists 1 outsourcing facilities (503B) in Minnesota, as of November 6, 2026; 0 show no inspection date and 1 were issued a Form 483.73