HUSKY Health does cover weight loss medication, but only two older oral drugs: orlistat (sold as Xenical) and phentermine. The GLP-1 injections most people are asking about, including Wegovy, Ozempic, and Mounjaro, are not covered by HUSKY when prescribed for weight loss alone.
The Two Weight Loss Drugs HUSKY Covers
Since July 1, 2025, HUSKY A, B, C, and D plans have covered orlistat (including the brand Xenical) and phentermine through the pharmacy benefit.1CT DSSMAP. Third Quarter 2025 Newsletter The federal government approved this coverage under State Plan Amendment 25-0014.2Medicaid.gov. Connecticut State Plan Amendment 25-0014
To qualify, you need a body mass index greater than 40, or a BMI greater than 35 with a diagnosed comorbid condition.3Connecticut Department of Social Services. SPA 25-0014 Website Notice
Every prescription requires prior authorization. The state must respond to a prior authorization request within two hours. If no authorization has been requested or granted yet, pharmacies must dispense an automatic 14-day supply, and a one-time five-day emergency supply is also available.2Medicaid.gov. Connecticut State Plan Amendment 25-0014
Why Wegovy, Ozempic, and Other GLP-1s Aren’t Covered for Weight Loss
Connecticut’s pharmacy benefit page states plainly that HUSKY does not cover drugs used to treat obesity.4Connecticut Department of Social Services. HUSKY Health Pharmacy Benefits GLP-1 agents like Ozempic appear on the HUSKY preferred drug list, but only with a diagnosis code for diabetes.5CT DSSMAP. HUSKY Health Preferred Drug List
The reason is cost. In fiscal year 2024, GLP-1 medications cost Connecticut’s Medicaid program $85 million after rebates, which was 35% of the entire pharmaceutical budget.6CT Mirror. CT GLP-1 Weight Loss Drug Coverage Without insurance, these drugs can run up to $1,000 per month. Under federal law, state Medicaid programs are permitted to exclude drugs prescribed for weight loss, even when they must cover the same drugs for other approved conditions like type 2 diabetes.7Kaiser Family Foundation. Medicaid Coverage of and Spending on GLP-1s
The Narrow Wegovy Exception
Starting November 3, 2025, HUSKY began covering Wegovy for two specific conditions, neither of which is weight management: metabolic-associated steatohepatitis (MASH, a serious form of fatty liver disease) and major adverse cardiovascular events (MACE). Both indications require strict clinical criteria and prior authorization.8CT DSSMAP. Provider Bulletin 2025-54: Wegovy Coverage for MASH and MACE
For the cardiovascular indication, you must be 18 or older, have a BMI of at least 27, a hemoglobin A1c of 6.5% or higher, and documented cardiovascular disease such as a prior heart attack or stroke. You cannot have type 1 or type 2 diabetes. To continue coverage, you must show at least a 5% weight loss from baseline.9CT DSSMAP. Wegovy for MACE Prior Authorization Form For the liver disease indication, the requirements include biopsy-confirmed steatohepatitis with fibrosis at stage F2 or F3, among other laboratory thresholds.10CT DSSMAP. Wegovy for MASH Prior Authorization Form Both authorizations explicitly exclude use for weight management.
If You Were Previously Getting a GLP-1 Through HUSKY
A small group of HUSKY members had been receiving GLP-1 coverage for weight loss. DSS described this as a bureaucratic oversight, and notified affected members that their coverage would end on June 15, 2025.6CT Mirror. CT GLP-1 Weight Loss Drug Coverage If you lost coverage, the oral drugs described above are the current HUSKY option, assuming you meet the BMI criteria.
What Could Change
Two 2025 legislative efforts aimed at broader coverage went in different directions. Senate Bill 1474 would have required HUSKY to cover FDA-approved GLP-1s for members with a BMI of 35 or higher. It passed the Human Services Committee 16-6 in March 2025 and reached the Senate calendar, but did not advance further during the session.11FastDemocracy. Connecticut SB 1474
House Bill 7192, which Governor Lamont signed on July 8, 2025, took a different approach. It directed the Commissioner of Social Services to petition the federal government to use patent rights over GLP-1 drugs and contract with generic manufacturers for cheaper versions. The law gave the commissioner 30 days to submit the petition and allowed Connecticut to join with other states to negotiate.12Yahoo Finance. Connecticut Wants to Make Generic GLP-1s Whether that produces lower-cost drugs that HUSKY would then cover depends on federal action.
Separately, a federal program called the BALANCE model opened to state Medicaid programs on a rolling basis starting May 1, 2026, with applications accepted through July 31, 2026. It offers states a way to negotiate lower GLP-1 prices with manufacturers.13Kaiser Family Foundation. What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid Connecticut has not publicly announced whether it plans to participate.
Federal rules are not expected to force the issue. A Biden-era proposed rule that would have required Medicaid programs to cover anti-obesity medications was dropped from the final rule released in April 2025, with CMS noting it reserves the right to revisit the question in future rulemaking.14Fierce Healthcare. Medicare Advantage Final Rule Excludes Anti-Obesity Drug Coverage
A Note on the State Employee Plan
You may have heard that Connecticut covers GLP-1s for weight loss. That coverage exists under the state employee health plan through a telehealth-based program called Flyte, operated by Intellihealth.15Connecticut Office of the State Comptroller. Comptroller Sean Scanlon Announces Continued Partnership With Intellihealth It is a separate program for state workers and their dependents, and it does not extend to HUSKY members.