Florida Medicaid and GLP-1s
Florida's rules for GLP-1s read as a diabetes document from the first line to the last. You need the diagnosis, the lab value and a metformin failure behind you. Wegovy, Zepbound and Saxenda aren't in the criteria, and they aren't in the drug list either — we counted.
What changed, and what the document says
The diagnosis you need
Not coveredType 2 diabetes. There's no second pathway anywhere in the document.
“Patient must have a diagnosis of type 2 diabetes mellitus; AND”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
The lab value you need
Conditions applyRecent, documented, and above the diagnostic line for diabetes.
“Hemoglobin A1C (HbA1c) ≥ 6.5 % measured within the past 6 months (documentation required); AND”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
Metformin comes first
Conditions applyA failed trial within two years, unless it's contraindicated. Documented either way.
“Patient must have trial and failure of metformin within the past 2 years unless contraindicated or the patient is intolerant to treatment (documentation required); AND”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
Which three drugs are preferred
ContextAll three are diabetes products, and even the preferred ones need paperwork.
“Preferred agents (Clinical Prior Authorization Required): Mounjaro® (tirzepatide), Ozempic® (semaglutide), and Trulicity® (dulaglutide)”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
How long an approval runs
CoveredA year at the outside, which is longer than most states on this site allow.
“LENGTH OF AUTHORIZATION: Up to one year”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
The four that are not preferred
ContextReachable, but only after a preferred one has already been tried and failed.
“Non-preferred agents: Exenatide, liraglutide (generic for Victoza), Rybelsus® (semaglutide), and Victoza® (liraglutide)”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
Minimum ages, drug by drug
ContextTen for three of them, eighteen for the two semaglutide products. The split follows the labeling, not the state.
“Patient must be ≥ 18 years of age for Ozempic, and Rybelsus, or patient must be ≥ 10 years of age for Mounjaro, Trulicity and Victoza; AND”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
Staying on it
Conditions applyContinuation turns on a lab number moving, not on the scale. Adverse effects that restrict treatment end it.
“Documentation of improved clinical response (e.g., decline in HbA1c); AND”
Florida Agency for Health Care Administration, Division: Pharmacy Policy — Revision Date: October 1, 2025, October 8, 2025, March 12, 2026
What clinical prior authorization means here
ContextNot an automated check. A human reads what the prescriber sends and decides.
“Clinical PA - These drugs require prior authorization submission that must include clinical documentation.”
Florida Agency for Health Care Administration — Effective July 1, 2026
What the state didn't publish
Wegovy, Zepbound and Saxenda appear nowhere in Florida Medicaid's drug list, and neither do the words obesity or weight loss.
We looked at 4687 documents to say that — every line of the Florida Medicaid Preferred Drug List effective July 1, 2026 — all 78 pages of it, read as text.
The same scan, in the same pass, found 50 occurrences of insulin, 36 of metformin, 6 of Mounjaro, 6 of tirzepatide, 4 of Trulicity and 3 each of Ozempic and semaglutide — so the scan finds drug names in this document. Against those same 4,687 lines, Wegovy, Zepbound, Saxenda, liraglutide, obesity, anti-obesity and weight loss each returned zero.
Checked September 2026 against Florida Medicaid Preferred Drug List, Florida Agency for Health Care Administration.
Which of these companies serve Florida?
Of the 101 companies we grade, 12 publish a list of the states they are licensed in. We checked 86 more and found no such list on any page we read; 3 we have not checked either way.
8 of those lists name Florida: Red Mountain Weight Loss, Gala Health, Care Bare Rx, Vita Bella, TelePeptide, Levity, WePeptideRx and Ways2Well. That is a licensure claim each company makes about itself, not something we checked with a state board.
A published list is a starting point, not a guarantee. If availability decides your choice, ask before you pay and get the answer in writing.
Sources
Each document below was fetched and read on the date shown beside it, which is the date printed on the document — not always the date in its web address. All of them were read in September 2026, the same session as the rest of this page.
- Glucagon-like Peptide-1 (GLP-1) Receptor Agonists and Dual glucose-dependent insulinotropic polypeptide (GIP) receptor/GLP-1 Receptor Agonists — Florida Agency for Health Care Administration, Division: Pharmacy Policy. the "Revision Date" line in the document header, which lists three revisions — the same header's "Original Effective Date" line is blank, so no effective date is supplied here: Revision Date: October 1, 2025, October 8, 2025, March 12, 2026.
- Florida Medicaid Preferred Drug List — Florida Agency for Health Care Administration. the effective date printed under the title on page one: Effective July 1, 2026.
Nothing on this page is medical advice, and nobody here is a clinician. Coverage rules change; check the linked document before you rely on it.
If you're paying cash instead
None of the above changes what a telehealth seller charges you. 1 of these 3 bills a fee every month on top of the medication, so the figure is the two added together. The other 2 say in the cell what we could capture and what we could not. Every number was read on the seller's own page; the adding up is ours.
PlushCare, Ro and Medi-Weightloss pay us nothing — none of the 3 below does. The buttons run through our own redirect so we can count the click, and counting is all they do.
| Grade | Provider | What a month actually costs | The one thing that matters here | Go to the provider |
|---|---|---|---|---|
| BMinor gap | PlushCare | No month-to-month medication price we could capture, so there is no monthly total to show.What they do bill every month: $19.99 a month for membership.Charged per visit rather than every month, so it is not in the figure above: $129 for visit, no insurance.The review says what else we found. | Puts both halves of its own price in one panel, $19.99 a month plus a $129 first visit, and states that medication isn't included. It prescribes; it doesn't sell the drug. | See its prices at PlushCare (opens in a new tab)Pays us nothing |
| BMinor gap | Ro | $349a month, medication onlybrand semaglutideMedication only. We captured no separate monthly charge on the pages we read, which is what we found rather than proof that nothing else is billed.Advertised at $199The lowest of the 2 medication prices we captured here | Publishes brand-name prices per drug and per dose, which is what you need if a diabetes-only rule sends you to cash. Zepbound runs $299 at the entry dose and $449 from 7.5mg up. | See its prices at Ro (opens in a new tab)Pays us nothing |
| CCaveat | Medi-Weightloss | $248a month, everything billed monthly$99 compounded semaglutide, first month + $149 a month for hormone optimization membershipThe only recurring monthly figure published anywhere on this company's site.The only figure published for this drug. No second-month rate appears on any page we read.The lowest of the 2 medication prices we captured hereCharged per visit rather than every month, so it is not in the figure above: $199 for new patient visit, $50 for visit cost with insurance, $49 for hormone optimization screener lab, $149 for hormone optimization full panel labs. | Prices the first month of everything and the second month of nothing — $99 compounded semaglutide and $199 compounded tirzepatide to start, with no recurring figure on any of the twenty pages we read. | See its prices at Medi-Weightloss (opens in a new tab)Pays us nothing |
Our grading method and how we verify a price explain what those letters mean and where these figures came from.