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Medicaid programs would reportedly be able to offer coverage starting in April 2026, while Medicare plans could do so in January 2027

In reality: Ambetter of Georgia, Florida, and Texas: Ozempic is Tier 4 (non-preferred brand) with prior authorization Ambetter of Illinois, Missouri, and Kansas: Ozempic is Tier 3 (preferred brand) with prior authorization Ambetter of North Carolina and Tennessee: Ozempic is Tier 3, but step therapy requires 90-day metformin trial first Ambetter of Arizona and Nevada: Ozempic is Tier 4, and the formulary prefers Trulicity (dulaglutide) as first-line GLP-1 This matters because Tier 3 copays range from $150 to $250 per month, while Tier 4 copays range from $300 to $400 per month on most Ambetter Silver and Bronze plans

PMID: 27517151

cognitive/mood claims are largely preclinical and not established in humans [5]

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