Does medi-cal cover weight loss medication in 2026?

No. Medi-Cal stopped covering GLP-1 drugs such as Wegovy, Zepbound and Ozempic for weight loss on January 1, 2026, under California’s 2025-26 state budget (Medi-Cal Rx). What Medi-Cal does cover for weight loss is its Diabetes Prevention Program, a year-long lifestyle program for members with prediabetes, and it still pays for GLP-1s prescribed for type 2 diabetes, heart disease, the liver disease MASH and, case by case, sleep apnea.

Below is exactly what changed, what is still covered, what to do if you were already taking one, and what a GLP-1 costs a Medi-Cal member who pays cash.

What changed on January 1, 2026

Medi-Cal Rx, the program that runs pharmacy benefits for Medi-Cal, announced the change on October 21, 2025. Every earlier approval for a weight-loss GLP-1 expired on December 31, 2025, and requests to continue therapy are denied. The letter Medi-Cal Rx mailed to members says the change is for all Medi-Cal members (DHCS).

Medi-Cal Rx last updated its drug-by-drug rules on April 6, 2026:

EPSDT is the federal Early and Periodic Screening, Diagnostic and Treatment benefit, which requires Medicaid to cover medically necessary care for people under 21. Medi-Cal Rx says it reviews weight-loss requests for those members for medical necessity.

Does Medi-Cal cover Ozempic?

For type 2 diabetes, yes. Ozempic is approved to improve blood sugar in adults with type 2 diabetes and to lower heart and kidney risks in that group, and it stays on Medi-Cal’s drug list with a type 2 diabetes restriction. For weight loss, no: using Ozempic for weight loss is off-label, and Medi-Cal Rx denies requests for diabetes GLP-1s used off-label for weight loss without a type 2 diabetes diagnosis.

Does Medi-Cal cover Wegovy?

Not for weight loss. Wegovy is still covered for noncirrhotic MASH, a fatty liver disease with scarring, and since April 1, 2026 that needs no prior authorization if the prescription carries a qualifying diagnosis code (K76.0 or K75.8). For cardiovascular disease, your prescriber sends a prior authorization request with the medical details, and Medi-Cal Rx reviews it case by case (Medi-Cal Rx, April 1, 2026).

Does Medi-Cal cover Zepbound?

Zepbound came off Medi-Cal’s drug list on January 1, 2026, so claims are denied whatever the reason for the prescription. Medi-Cal Rx still considers prior authorization requests for obstructive sleep apnea, one of Zepbound’s FDA-approved uses. Our guide to Zepbound for sleep apnea covers what those requests usually ask for.

If you were already taking a GLP-1 for weight loss

Your approval ended on December 31, 2025, even if it ran later on paper. Medi-Cal Rx suggests asking your doctor about other options, such as other drugs, diet changes, exercise and counseling. Three things to know:

• You can appeal. If you get a Notice of Action denying a GLP-1, you generally have 90 days from that notice to ask the California Department of Social Services for a State Hearing (Medi-Cal Rx FAQ, April 6, 2026). To keep a medication you already take while the hearing is pending, the request generally has to go in within 10 days of the notice.
• You can pay yourself, but you won’t be paid back. Medi-Cal Rx says members can pay out of pocket at the pharmacy, and that it won’t reimburse GLP-1s bought for weight loss.
• Check for another approved use. If you have type 2 diabetes, heart disease, MASH or sleep apnea, ask your doctor whether a request for that use fits your situation.

For questions, the Medi-Cal Rx Customer Service Center is at 1-800-977-2273, 24 hours a day.

The Medi-Cal weight loss program: Diabetes Prevention Program

Medi-Cal’s main weight-loss benefit is the Diabetes Prevention Program (DPP), a covered benefit since January 1, 2019 (DHCS). It’s a lifestyle program, not a medication:

• It lasts a year, with at least 22 sessions led by a trained lifestyle coach.
• The curriculum focuses on weight loss through exercise, healthy eating and behavior change.
• Members who reach and keep a 5% weight loss from the first session can keep going with less intensive maintenance sessions.
• It’s for full-scope Medi-Cal members with prediabetes who meet the CDC’s program eligibility rules.

Medi-Cal managed care plans run their own versions. Health Net’s Medi-Cal Diabetes Prevention Program, for example, is a 12-month program through the Diabetes Care Partners app with a health coach and online classes, free for members who qualify. To start, ask your doctor about a prediabetes test and a referral, or call the member services number on your plan card.

If you also have Medicare

People with both Medi-Cal and Medicare should look at the Medicare GLP-1 Bridge, which runs from July 1, 2026 to December 31, 2027. Eligible Part D enrollees pay $50 a month for Wegovy, Foundayo or the Zepbound KwikPen for weight loss, and Medicare.gov lists Special Needs Plans among the Part D coverage it works with. Low-income subsidies don’t apply to the $50 copay (CMS). Our Medicare guide covers who qualifies.

Paying cash in California

If you pay yourself, these are the makers’ self-pay prices as of October 27, 2026:

Manufacturer savings cards that cut insured costs to as little as $25 a month exclude people with government insurance, Medi-Cal included. Novo Nordisk’s Ozempic offer page says people with government coverage can still pay its self-pay price. Costco’s member prices match NovoCare’s for Wegovy at the doses Costco lists; see our Costco GLP-1 price guide.

Online programs charge less for compounded GLP-1s. At the 26 programs we rank, as of November 2026, compounded semaglutide costs $65 to $299 a month and compounded tirzepatide $85.58 to $378.08, at each program’s lowest ongoing price. Not every program serves California: Collective and DudeMeds, for example, don’t. Our California page lists the programs that do, and our cheapest GLP-1 rankings sort programs by price.

A compounded GLP-1 is not Wegovy, Ozempic or Zepbound, and not a generic of them. A compounding pharmacy prepares it, it isn’t FDA-approved, and the FDA does not review compounded drugs for safety, effectiveness or quality (FDA). Read our compounded GLP-1 guide before you choose that route, and compare all cash options in our guide to GLP-1s without insurance.

Why California made the change

Medi-Cal Rx tied the change to the enacted 2025-26 state budget and its aim to reduce pharmacy spending. California wasn’t alone. KFF counted 16 state Medicaid programs covering GLP-1s for obesity in October 2025 and 13 in January 2026, after California, New Hampshire, Pennsylvania and South Carolina ended coverage and North Carolina, which had dropped it in October 2025, brought it back in December. Federal rules let states choose whether to cover weight-loss drugs, while coverage for diabetes, heart disease and sleep apnea is required. Our state-by-state Medicaid guide shows where coverage stands now.

The bottom line

Medi-Cal doesn’t cover GLP-1s for weight loss alone in 2026, for any adult member. It still covers Ozempic, Mounjaro and other diabetes GLP-1s for type 2 diabetes, Wegovy for MASH and, with prior authorization, heart disease, and Zepbound case by case for sleep apnea. Members under 21 can still be approved under EPSDT.

For weight loss itself, Medi-Cal’s covered option is the Diabetes Prevention Program for members with prediabetes. If you decide to pay for a GLP-1 yourself, compare the makers’ self-pay prices with online programs, and talk with a licensed clinician about which drug fits your health. More options are on our weight-loss hub.