MedicaidCoverageMedium impact
MSA 21-49
Michigan Medicaid - MDHHS·MI · Endocrinology, Family Medicine, Internal Medicine +2 more·Provider Bulletin
Effective date
Feb 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan Medicaid will begin covering anti-obesity prescription drugs effective February 1, 2022. These medications require prior authorization and will be billed directly to the state's Pharmacy Benefit Manager (PBM), with copayments applying for beneficiaries 21 and older.
Action Required
Before February 1, 2022: Billing team must update pharmacy billing procedures to submit anti-obesity drug claims directly to MDHHS contracted PBM instead of medical claims. Ensure prior authorization is obtained for all covered anti-obesity medications listed in the policy. Update patient financial counseling to inform Medicaid beneficiaries age 21+ about applicable copayments.