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When Ozempic coverage makes sense: You have type 2 diabetes with HbA1c ≥ 7.0% You meet the BMI and step therapy requirements You're willing to accept the 2 mg maximum dose You understand that weight loss at 2 mg is less than at 2.4 mg but still clinically meaningful When compounded semaglutide makes more sense: You don't have diabetes (no coverage path exists) You have diabetes but don't want to wait for prior authorization (typically 7 to 14 days) You want the full 2.4 mg dose for maximum weight loss You want to avoid the step therapy requirement (90-day metformin trial) The 2027 policy outlook and pending legislation Two bills currently under consideration in the Massachusetts legislature could change MassHealth's obesity coverage policy
