С 1 января 2026 года программа Medi-Cal Rx обновит покрытие расходов на препараты, содержащие GLP-1. Read about the extent of the changes here.
Что меняется
Wegovy, Zepbound and Saxenda will be removed from the Contract Drugs List (CDL) and will not be covered for weight loss or weight-loss indications.
Other GLP-1 drugs (Ozempic, Rybelsus, Mounjaro, Victoza, Byetta, Bydureon, Trulicity) will remain on the CDL with a Code I diagnosis restriction for type 2 diabetes, but will not be covered for weight loss.
Prior authorization requests for weight loss for members under age 21 may be reviewed for medical necessity, consistent with EPSDT requirements.
For more information
For questions, contact Medi-Cal Rx Customer Service at 1-800-977-2273 or [email protected].
