New Hampshire Medicaid does not cover Wegovy or Zepbound for weight loss

Since January 1, 2026, New Hampshire Medicaid no longer covers GLP-1 medications such as Wegovy, Zepbound and Saxenda when they are prescribed only for weight loss, and the weight management class was removed from the preferred drug list. GLP-1s stay covered for other conditions, such as type 2 diabetes, cardiovascular risk reduction, severe obstructive sleep apnea and MASH, under separate prior authorization criteria.1234

There is no prior authorization path for GLP-1s prescribed only for weight loss: the weight management criteria cover only non-GLP-1 drugs. Wegovy and Zepbound can be approved for other uses under their own criteria, and those requests are denied when the drug is used solely for chronic weight management.4789

• Weight management criteria (phentermine, phentermine/topiramate, orlistat): the requested drug must not be a GLP-1 receptor agonist.
• Wegovy, cardiovascular risk (MACE) path: a documented 3-month low-calorie diet trial, increased physical activity including strength training, a baseline BMI of 27 or more, established cardiovascular disease, current guideline-recommended secondary prevention therapy, and no type 1 or type 2 diabetes diagnosis. First approval lasts 6 months, renewals 12 months.
• Zepbound, obstructive sleep apnea path: a documented 3-month low-calorie diet trial, increased physical activity including strength training, a baseline BMI of 27 or more, moderate to severe sleep apnea confirmed by an apnea-hypopnea index of 15 or higher on an in-lab sleep study, at least 70% PAP adherence over the last 6 months, and no type 1 or type 2 diabetes diagnosis. First approval lasts 6 months, renewals 12 months.
• Wegovy, MASH path: age 18 or older, prescribed by or with a gastroenterologist or hepatologist, MASH with moderate to advanced fibrosis shown by biopsy, elastography or a listed blood test, liver fat of 8% or more on MRI-PDFF, statin use unless not tolerated, and lifestyle changes. Approval lasts 12 months.

Coverage for other uses the FDA has approved:

• Wegovy (injection), reduction of the risk of major adverse cardiovascular events in adults with established cardiovascular disease and a BMI of 27 or more, without diabetes: Covered with prior authorization7
• Wegovy (injection), MASH with moderate to advanced (F2 to F3) liver fibrosis in adults: Covered with prior authorization9
• Zepbound, moderate to severe obstructive sleep apnea in adults with obesity, without diabetes: Covered with prior authorization8

What changed, and when:

CMS BALANCE model: CMS's BALANCE model page names no participating states, and we found no New Hampshire Medicaid announcement that the state has joined.13

The State Health Benefit Plan for state employees and retirees does not cover GLP-1 medications for weight loss, according to an August 2025 Department of Administrative Services request to the Governor and Executive Council. Its prescription drug benefits are administered by Express Scripts.14

Pharmacy benefit: Express Scripts (prescription drug benefits), under the Department of Administrative Services, Division of Risk and Benefits.

Marketplace (ACA) plans: New Hampshire's essential health benefits benchmark plan, an Anthem small-group HMO, excludes any drug mainly used for weight loss.1718

On the fee-for-service preferred drug list effective November 1, 2026, Ozempic, Trulicity, Victoza and generic exenatide are preferred, and Mounjaro and Rybelsus are non-preferred. Each needs a type 2 diabetes diagnosis and a trial of an oral diabetes drug; a non-preferred drug also needs trials of two preferred drugs.56

In 2025, New Hampshire Medicaid paid for 34,291 GLP-1 prescriptions, $37.3 million before rebates: 24 per 1,000 residents, against 32 across the states and DC, 25th of 51.65 It reimbursed 8 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 50 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 2027.4041313227352030

• 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.2728292035363738393433
• 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.222420

In 2024, Medicare Part D drug plans paid for 82,446 GLP-1 claims from prescribers in New Hampshire, $106.8 million in total drug cost.66

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.70 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 New Hampshire 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 B12.7172 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 New Hampshire’s board of pharmacy or attorney general on their own sites.

The FDA’s register lists 0 outsourcing facilities (503B) in New Hampshire, as of November 6, 2026.67