Michigan GLP-1 Coverage and Costs After Medicaid's 2026 Cut

Does Michigan Medicaid cover GLP-1s for weight loss?

Only in narrow cases. Since January 1, 2026, Michigan Medicaid covers GLP-1 medications such as Wegovy, Zepbound, Saxenda and liraglutide for obesity alone only with prior authorization under much stricter criteria, and coverage for that use, including continuation requests, was reduced ⁸. Under Michigan Department of Health and Human Services (MDHHS) provider letter L 25-73, the patient must be classified as morbidly obese, must have documented failure of all other clinically appropriate weight-loss interventions (including a trial and failure of Preferred Drug List-preferred anti-obesity agents), and coverage may be considered only as a measure to avert the need for higher-cost bariatric surgery ⁸. The change follows Public Act 22 of 2025, the fiscal year 2026 state budget ⁸. The prior-authorization requirement itself is longstanding: the Pharmacy Provider Manual (Section 8.5.B, "Anti-Obesity," revised April 1, 2026) lists the anti-obesity class as requiring prior authorization ¹.

The letter does not state a BMI number. Aetna's 2026 criteria for its Michigan HIDE plan (for people enrolled in both Medicare and Medicaid) give a baseline BMI of 40 or higher as an example of morbid obesity ¹⁰. Most Michigan Medicaid beneficiaries are enrolled in a Medicaid Health Plan rather than fee-for-service, and the statewide Common Formulary sets a floor plans cannot be more restrictive than ¹. Check with your Medicaid health plan for the exact criteria that apply to you.

Not everything changed. Coverage of GLP-1 medications requested for other existing indications, such as type 2 diabetes, is not changing ⁸. Priority Health, a Michigan Medicaid health plan, states that its coverage of GLP-1s approved for type 2 diabetes (such as Ozempic and Mounjaro) will not change, and that its Wegovy and Zepbound criteria include non-weight-loss indications such as reducing major adverse cardiovascular events or severe obstructive sleep apnea, with prior authorization required for all indications ⁹. People approved before January 1, 2026 were not cut off at once: their authorizations are honored for the remainder of the authorization period, after which the new criteria apply at renewal ⁸⁹.

What GLP-1 care costs in Michigan

Because Michigan Medicaid now approves GLP-1s for obesity alone only under strict prior-authorization criteria ⁸, patients who do not meet them face a choice between another covered indication, if one applies, and paying cash. Cash pricing is what sits on the other side.

Astra's price in Michigan is the same as everywhere else we operate: compounded semaglutide from $68 per month and compounded tirzepatide from $118 per month on 12-month plans ($816 and $1,416 billed annually), the same price at every dose. There is no Michigan-specific discount or markup.

Median household income in Michigan is $72,389 ⁶ and roughly 5.1% of residents are uninsured ⁵, both ACS 2024 1-year estimates.

Access and clinician supply

HRSA counts 606 active Primary Care Health Professional Shortage Area designations statewide (pull dated Aug 27, 2026) — a mix of geographic-area, population-group, and single-facility designations ⁷. These overlap the same residents, so HRSA's data cannot be summed to a clean population-affected figure; only the designation count is reportable.

Specialist access for weight management thins out fast outside Michigan's larger metros, which is precisely where a video visit substitutes for a drive.

Telehealth prescribing rules in Michigan

Michigan law allows telehealth prescribing. Under MCL 333.16285, a health professional providing a telehealth service may prescribe a drug if they are a prescriber acting within their scope of practice. When medically necessary, they must refer the patient to nearby care, including emergency services, and after the visit they (or someone under their delegation) must be available for follow-up care or refer the patient to another provider ¹¹. Whether Medicaid covers a prescription is a separate question from whether it can be prescribed by telehealth.

Availability

Astra is licensed to treat patients in all 50 states, including all of Michigan — not only the three cities with their own pages.