MedicaidCoverageMedium impact
Notice of Zepbound Coverage, Effective February 5, 2025
Maryland Medicaid·MD · Endocrinology, Family Medicine, Internal Medicine +1 more·Managed Care Organizations
Effective date
Feb 5, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid managed care plans will begin covering Zepbound (tirzepatide) for weight management effective February 5, 2025. This adds a new covered medication option for eligible patients under Maryland Medicaid MCO plans.
Action Required
By February 5, 2025: Billing team should verify coverage requirements and prior authorization protocols for Zepbound prescriptions under Maryland Medicaid MCO plans. Contact individual MCO plans to confirm specific coverage criteria, prior authorization requirements, and preferred pharmacy networks for tirzepatide claims.