UnitedHealthcareMedium ImpactCoverage

North Carolina Medicaid: Updated coverage for GLP-1 medications

Published March 1, 2026Effective December 12, 2025

AI Summary

North Carolina Medicaid is reinstating coverage for GLP-1 medications (Wegovy, Zepbound, Saxenda) for weight management effective December 12, 2025. Wegovy is preferred, while Zepbound and Saxenda require prior authorization with step therapy or documented contraindication to Wegovy.

Action Required

By December 12, 2025: Billing team must update prior authorization workflows for GLP-1 weight management medications in NC Medicaid. Configure system to require step therapy documentation showing Wegovy trial/failure OR contraindication before approving Zepbound or Saxenda. Update clinical criteria at http://nctracks.nc.gov/content/public/providers/pharmacy/pa-drugs-criteria-new-format.html. Providers should assess patients for treatment gaps and appropriate starting doses.

Plan Types

Medicaid

States

NC

Specialties

endocrinology, family-medicine, internal-medicine, ob-gyn