# Does Connecticut HUSKY Cover Wegovy or Zepbound? Forms, Tests and the 2025 Law Change By Nora Bissett, Pricing Editor (https://glpwatchdog.org/authors/nora-bissett) | Published: 2026-11-06 Canonical page: https://glpwatchdog.org/research/connecticut-husky-glp1-coverage > Connecticut once wrote obesity-drug coverage into Medicaid law, then the 2025 budget made it optional. What HUSKY Health covers now: Wegovy for heart risk or MASH, Zepbound for sleep apnea, Mounjaro and Ozempic for diabetes, the Letter of Medical Necessity route and hearings. ## Key points - No HUSKY form exists for Wegovy or Zepbound for weight loss alone; the state plan lists only orlistat and phentermine as weight-loss drugs. - A 2023 law required obesity-drug coverage above BMI 35; the 2025 budget made it optional, pending a federally approved plan change. - Wegovy for heart risk needs a BMI of at least 27, an A1c under 6.5% and a prior heart attack, stroke or artery disease. - Zepbound for sleep apnea needs an AHI of 15 or more, a BMI of at least 30 and ongoing PAP use. - Requests that miss a form's tests can be sent for a Letter of Medical Necessity review by email. No. As of November 2026, Connecticut’s HUSKY Health program has no prior authorization route for Wegovy, Zepbound or another GLP-1 prescribed for weight loss alone; the only forms the state posts are for heart-risk reduction, the liver disease MASH, sleep apnea and type 2 diabetes.[5][1][2][3] A 2023 law had required obesity-drug coverage for members with a BMI over 35, but the 2025 budget act removed that requirement and made such coverage optional.[7] > **About this article.** HUSKY Health is the name of Connecticut’s Medicaid and children’s health insurance programs, run by the Department of Social Services. This page reads the department’s prior authorization forms, its client notice on GLP-1 denials, the approved state plan and the state statute as they stood on November 6, 2026. For the federal rule that lets states leave weight-loss drugs out, see [why Medicaid treats Ozempic and Wegovy differently](https://glpwatchdog.org/research/does-medicaid-cover-ozempic-and-wegovy). ## Does HUSKY cover Wegovy or Zepbound for weight loss? Not through any published route. The heart-risk and sleep apnea forms say the drug is not covered when the request fails their tests, and the diabetes form requires a type 2 diabetes diagnosis code on every new prescription.[1][3][4] The department’s notice to members who are turned down at the pharmacy says the same thing in plain terms: the medication needs a diagnosis code showing type 2 diabetes.[6] Federal law gives states the option to leave weight-loss drugs out of Medicaid.[9] Connecticut’s state plan, in an amendment federal regulators approved effective June 1, 2025, covers only two weight-loss drugs: orlistat and phentermine, with brand-name Xenical in place of orlistat depending on net cost or availability.[15] ## What happened to Connecticut's law on obesity drugs? It was rewritten. Section 17b-278l, passed in 2023 and effective July 1 of that year, directed the commissioner to cover FDA-approved obesity drugs for Medicaid and HUSKY B members with a BMI above 35.[7] The 2025 budget act, effective July 1, 2025, deleted that mandate. The statute now describes the coverage as optional, says the department provides it only once a state plan amendment is approved, and narrows the drugs it covers to obesity drugs for people with type 2 diabetes and drugs for a related condition in people with obesity, after prior authorization and step therapy.[7] The rewritten law also caps any required step therapy at 180 days, waives it when BMI is 40 or higher and a provider certifies that surgery under anesthesia is scheduled within six months, and asks the commissioner to report GLP-1 use and costs to the legislature every year from January 15, 2026.[7] Another 2025 addition told the department to petition the federal government about lower-cost generic GLP-1s.[7] As of November 6, 2026, the department’s pharmacy page listed no GLP-1 form for obesity without one of the conditions below.[5] ## When will HUSKY approve Wegovy or Zepbound? Each of the three non-diabetes uses on these drugs’ labels has its own form.[10][11] Every one of those forms is limited to adults 18 and older, and each also asks for a treatment plan with active diet, activity or behavioral changes.[1][2][3] *HUSKY Health prior authorization forms for Wegovy and Zepbound, as posted November 6, 2026* | Use and form date | Main tests | Who is turned away | Renewal | | --- | --- | --- | --- | | Wegovy for heart risk (May 2025) | BMI ≥ 27; A1c under 6.5%; prior heart attack, ischemic or hemorrhagic stroke, or symptomatic peripheral artery disease | Anyone with type 1 or type 2 diabetes or class IV heart failure | At least 5% weight loss from baseline, still in a lifestyle program | | Wegovy for MASH (June 2026) | A1c under 9.5%; biopsy-documented steatohepatitis, fibrosis stage F2 or F3 and an activity score of 4 or more; MELD 12 or less; liver enzymes no more than 5 times normal | Fibrosis outside F2 to F3; other liver disease; alcohol above 20 g a day for women or 30 g for men | Not listed on the form | | Zepbound for sleep apnea (July 2025) | AHI ≥ 15; BMI ≥ 30; now using PAP and will keep using it, unless PAP is contraindicated | Anyone with type 1 or type 2 diabetes, or central or mixed sleep apnea | AHI down at least 25% from baseline and PAP continued | Two details matter most. First, the heart and sleep apnea forms exclude people with diabetes, who are sent to the diabetes GLP-1s instead.[1][3] Second, the MASH form asks for a liver biopsy result, since it requires histologic documentation along with the fibrosis stage and activity score.[2] Our guides to [Zepbound for sleep apnea](https://glpwatchdog.org/research/zepbound-for-sleep-apnea) and [GLP-1s and MASH](https://glpwatchdog.org/research/glp1-and-fatty-liver-mash) explain the evidence behind those uses. ## Does HUSKY cover Ozempic and Mounjaro for diabetes? Yes. The diabetes form dated July 1, 2026 lists Mounjaro, the Ozempic pen, Trulicity, Victoza and Byetta as preferred, each needing a diagnosis code. Ozempic tablets, Rybelsus, generic liraglutide and generic exenatide are non-preferred.[4] A non-preferred drug needs a 30-day trial and failure of one preferred GLP-1, or a documented reason that none can be used, and stomach side effects alone do not count as intolerance unless the prescriber justifies stopping.[4] ## What if a request does not fit the form? Connecticut prints a fallback on the forms themselves. When a request fails the criteria, each of the three forms says a Letter of Medical Necessity must be reviewed, emailed to rx.lmn@ct.gov, and points to the state’s definition of medical necessity.[1][2][3] That definition covers services needed to treat or ameliorate a medical condition that are consistent with accepted medical standards and no more costly than an equally effective alternative.[8] A strong letter cites the person’s own diagnoses, the treatments already tried and published evidence. It is a review, not a promise of approval. ## How do you appeal a HUSKY denial? - **Requests.** Prescribers fax the form to 1-866-759-4110; the pharmacy prior authorization line is 1-866-409-8386.[1] - **Hearings.** A member can ask in writing for a hearing by writing to the department’s hearings office (OLCRAH) at 55 Farmington Avenue, Hartford, CT 06105-3725, or by fax to (860) 424-5729. Questions about hearings go to 1-800-462-0134.[6] - **Deadline.** Use the date on your denial notice. The department’s GLP-1 notice gives no day count, so file soon.[6] A hearing has the most to work with when the dispute is over a covered use, such as whether a sleep study or PAP record was enough. Our walkthrough of [prior authorization and appeals](https://glpwatchdog.org/research/glp1-prior-authorization-and-appeals) covers what to send, and the [state Medicaid GLP-1 checker](https://glpwatchdog.org/tools/state-medicaid-glp1-checker) compares Connecticut with other states. ## What about children and teens on HUSKY? Wegovy’s label includes obesity treatment from age 12, but all three HUSKY forms are for adults.[10][1] Federal law requires Medicaid to provide necessary treatment found through child health screening for people under 21, even when the state plan does not cover it.[12] We found no Connecticut document that applies that rule to GLP-1s. A family can use the Letter of Medical Necessity route and ask for review under EPSDT, the federal child-health benefit, by name. ## What are the options without coverage? For weight loss alone, the drugs in HUSKY’s state plan are orlistat and phentermine, so ask the prescriber whether either fits.[15] For Wegovy or Zepbound, paying cash is the main route. Lilly’s savings card for insured patients excludes Medicaid enrollees.[13] Self-pay prices in the figures we track are $349 a month for most Wegovy pen doses from Novo Nordisk, and from $299 at the starting dose, $399 at 5 mg and $449 at higher doses refilled on time for Lilly’s Zepbound.[13][14] Check each offer’s terms on government-program enrollment first. Our list of the [cheapest GLP-1 routes without insurance](https://glpwatchdog.org/research/cheapest-glp1-without-insurance) compares them, and the [Connecticut page](https://glpwatchdog.org/states/connecticut) lists sellers that ship to the state. ## Frequently asked questions ### Does HUSKY cover Wegovy for weight loss? No. As of November 2026, HUSKY Health posts no prior authorization route for Wegovy for weight loss alone, and its state plan covers only orlistat and phentermine as weight-loss drugs. Wegovy can be approved for an adult without diabetes who has had a heart attack, stroke or symptomatic artery disease and has a BMI of at least 27, or for MASH when a biopsy shows F2 or F3 scarring. ### Does HUSKY cover Zepbound? Only for obstructive sleep apnea in adults with an apnea-hypopnea index of at least 15 and a BMI of at least 30 who are using PAP therapy. People with diabetes or central sleep apnea are turned away on that form. Renewal needs at least a 25% drop in the apnea index. ### Does HUSKY cover Ozempic or Mounjaro? Yes, for type 2 diabetes. The Ozempic pen and Mounjaro are both preferred on the July 2026 diabetes form, and each new prescription needs a diagnosis code for type 2 diabetes. ### Didn't Connecticut pass a law requiring Medicaid to cover weight-loss drugs? It did in 2023, for members with a BMI over 35. The 2025 budget act removed that requirement effective July 1, 2025. The law now treats the coverage as optional and ties it to an approved state plan amendment. ### How does the HUSKY Letter of Medical Necessity work? It is a request for review when a GLP-1 request does not meet the form's criteria. The forms say to email it to rx.lmn@ct.gov with all relevant information on why the drug is medically necessary under Connecticut's definition. ## References 1. Connecticut Department of Social Services CT Medical Assistance Program: Wegovy for MACE (Major Adverse Cardiovascular Events) Prior Authorization Request Form (May 2025). ctdssmap.com. 2025. https://www.ctdssmap.com/CTPortal/Information/Get-Download-File?Filename=Wegovy_MACE_PA_Form.pdf&URI=Forms/Wegovy_MACE_PA_Form.pdf 2. Connecticut Department of Social Services CT Medical Assistance Program: Wegovy for MASH Prior Authorization Request Form (June 2026). ctdssmap.com. 2026. https://www.ctdssmap.com/CTPortal/Information/Get-Download-File?Filename=Wegovy_MASH_PA_Form.pdf&URI=Forms/Wegovy_MASH_PA_Form.pdf 3. Connecticut Department of Social Services CT Medical Assistance Program: Zepbound for Treatment of Obstructive Sleep Apnea Prior Authorization Request Form (July 2025). ctdssmap.com. 2025. https://www.ctdssmap.com/CTPortal/Information/Get-Download-File?Filename=Zepbound_for_OSA_PA_Form.pdf&URI=Forms/Zepbound_for_OSA_PA_Form.pdf 4. Connecticut Department of Social Services Hypoglycemics, Incretin Mimetics/Enhancers (GLP-1/GIP Agonists for Use in Diabetes) Clinical Prior Authorization Request Form (July 1, 2026). ctdssmap.com. 2026. https://www.ctdssmap.com/CTPortal/Information/Get-Download-File?Filename=GLP-1_form.pdf&URI=Forms/GLP-1_form.pdf 5. Connecticut Department of Social Services; Gainwell Technologies Connecticut Medical Assistance Program: Pharmacy Information. ctdssmap.com. 2026. https://www.ctdssmap.com/CTPortal/Pharmacy%20Information/tabId/54/Default.aspx 6. Connecticut Department of Social Services Notice to HUSKY Health clients on GLP-1 prescription denials (GLP1 Flyer). ctdssmap.com. 2026. https://www.ctdssmap.com/CTPortal/Portals/0/StaticContent/Publications/GLP1_Flyer.pdf 7. Connecticut General Assembly Conn. Gen. Stat. §17b-278l: Medical assistance for obesity treatment, surgery (2026 Supplement, chapter 319v). cga.ct.gov. 2026. https://www.cga.ct.gov/2026/sup/chap_319v.htm 8. Connecticut General Assembly Conn. Gen. Stat. §17b-259b: Medically necessary and medical necessity defined (chapter 319v). cga.ct.gov. 2025. https://www.cga.ct.gov/current/pub/chap_319v.htm 9. United States Code 42 U.S.C. §1396r-8: Payment for covered outpatient drugs (Social Security Act §1927). Legal Information Institute, Cornell Law School. 2026. https://www.law.cornell.edu/uscode/text/42/1396r-8 10. Novo Nordisk WEGOVY (semaglutide) injection and tablets: prescribing information. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b 11. Eli Lilly and Company ZEPBOUND (tirzepatide) injection: prescribing information. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b 12. United States Code 42 U.S.C. §1396d: Definitions, including early and periodic screening, diagnostic, and treatment services (subsection r). Legal Information Institute, Cornell Law School. 2026. https://www.law.cornell.edu/uscode/text/42/1396d 13. Eli Lilly and Company Zepbound savings and self-pay options, with card terms. zepbound.lilly.com. 2026. https://zepbound.lilly.com/savings 14. Novo Nordisk Wegovy savings offer. novocare.com. 2026. https://www.novocare.com/obesity/products/wegovy/savings-offer.html 15. Centers for Medicare & Medicaid Services Connecticut State Plan Amendment 25-0014: excluded drug listing, weight loss medications limited to orlistat and phentermine (effective June 1, 2025). medicaid.gov. 2025. https://www.medicaid.gov/medicaid/spa/downloads/CT-25-0014.pdf --- Cite as: GLP Watchdog, Nora Bissett, "Does Connecticut HUSKY Cover Wegovy or Zepbound? Forms, Tests and the 2025 Law Change", published 2026-11-06. https://glpwatchdog.org/research/connecticut-husky-glp1-coverage Canonical HTML page: https://glpwatchdog.org/research/connecticut-husky-glp1-coverage Medical disclaimer: Nothing here is medical advice. We report on this subject; we do not treat anyone. Whether to begin a medication, supplement, or treatment, whether to adjust it, and whether to stop are questions for a clinician licensed to answer them, who knows your history.