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

Mississippi Medicaid covers selected drugs to treat obesity. On its Universal Preferred Drug List effective Nov. 1, 2026, Foundayo, Saxenda, Wegovy and Zepbound are preferred anti-obesity agents, and every anti-obesity agent needs a manual prior authorization. Wegovy's quantity limits include tablets as well as pens and vials. A notice from the October 2026 P&T Committee says Saxenda is recommended to move to non-preferred on Jan. 1, 2027.1234

All anti-obesity agents need a manual prior authorization under the Division's Select Anti-Obesity Agents criteria (version 11, effective July 1, 2026). The detailed BMI and condition rules of the current version could not be read; the rules below are the ones printed on the drug list.13

• Foundayo, Wegovy and Zepbound: a manual prior authorization and clinical review may be needed when the electronic (DUR+) criteria are not met.
• Reauthorization after 12 months needs a manual prior authorization to confirm that therapy is still appropriate.
• Using a GLP-1 together with an anti-obesity agent needs clinical review.
• Quantity limits: 30 tablets per 30 days for Foundayo and Wegovy tablets; 2 mL per 28 days for Wegovy 0.25, 0.5 and 1 mg; 3 mL per 28 days for Wegovy 1.7, 2.4 and 7.2 mg and for Zepbound.

What changed, and when:

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

The plan document revised Jan. 1, 2026 excludes weight-loss drugs. It considers Wegovy only, with prior authorization through CVS Caremark, to lower the risk of major cardiovascular events or for MASH, and Zepbound only for moderate-to-severe obstructive sleep apnea with obesity. The plan offers a no-cost weight management counseling program through ActiveHealth for members with a BMI of 30 or more.101112

Pharmacy benefit: CVS Caremark (pharmacy benefit manager); Blue Cross & Blue Shield of Mississippi (medical claims).

Marketplace (ACA) plans: Mississippi's essential health benefits benchmark plan, a Blue Cross & Blue Shield of Mississippi Network Blue small-group plan, excludes drugs used for weight reduction and lists weight loss programs as not covered.1415

On the Universal Preferred Drug List effective Nov. 1, 2026, Byetta, Mounjaro, Ozempic, Trulicity and Victoza are preferred GLP-1 diabetes drugs, and Rybelsus is non-preferred. A preferred drug needs a documented type 2 diabetes diagnosis and no GLP-1 therapy for obesity in the past 30 days; a non-preferred drug needs clinical review.5

In 2025, Mississippi Medicaid paid for 61,346 GLP-1 prescriptions, $70.5 million before rebates: 21 per 1,000 residents, against 32 across the states and DC, 30th of 51.66 It reimbursed 9 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 62 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 2027.4142323328362131

• 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.2829302136373839403534
• 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.232521

In 2024, Medicare Part D drug plans paid for 249,278 GLP-1 claims from prescribers in Mississippi, $310.3 million in total drug cost.67

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.71 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 Mississippi 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 B12.7273 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.

Mississippi's Board of Medical Licensure lets its licensees prescribe a compounded GLP-1 or GIP drug only when a patient has a specific clinical need not met by a commercially available product or the drug is on the FDA drug shortage list, and only after confirming the supplying pharmacy's ingredient verification testing. We found no Mississippi law or rule aimed specifically at shipping compounded GLP-1s into the state.16171819

The FDA’s register lists 1 outsourcing facilities (503B) in Mississippi, as of November 6, 2026; 0 show no inspection date and 1 were issued a Form 483.68