Coverage and access · TX
Texas traditional Medicaid publishes separate Wegovy and Zepbound authorization criteria, revised May 8, 2026. Medicaid, Medicare and private insurance follow different rules. Start with your coverage route below, then compare care or cash-pay options if needed.
Our dated policy sources appear below; a summary is not an individual approval. This page is information, not medical advice or a benefit determination.
Texas traditional Medicaid publishes separate Wegovy and Zepbound authorization criteria, revised May 8, 2026. Wegovy has cardiovascular-risk criteria from age 45 and an injection-specific noncirrhotic MASH pathway from age 18. Zepbound's criteria address adults with obesity and moderate-to-severe obstructive sleep apnea. These are indication-specific request routes, not a general weight-loss benefit or guaranteed coverage for every listed product code. The documents explicitly require checking current formulary coverage. Managed-care members should also confirm their plan's implementation. Ask the prescriber to match the diagnosis, formulation, product code and documentation to the relevant current policy.
Texas traditional Medicaid Wegovy clinical criteria, May 8, 2026Policy source checked September 26, 2026
Texas traditional Medicaid Zepbound clinical criteria, May 8, 2026Policy source checked September 26, 2026
Ask whether the policy applies to your age, diagnosis and fee-for-service or managed-care benefit. A preferred-drug-list entry is not approval for every use, and a weight-management restriction does not answer every diabetes or other medical-indication question.
Check Texas Health and Human ServicesMedicare's GLP-1 Bridge uses federal rules across states. It is separate from Texas Medicaid, and it is not ordinary Part D coverage. Your prescription's purpose determines which route to check. CMS explains the distinction.
Start with your state program. If a managed-care plan administers your drug benefit, use the member-services number on your card to confirm its criteria and how to request a written decision.
Texas Health and Human ServicesYour State Health Insurance Assistance Program (SHIP) offers free, impartial Medicare counseling. It can help you understand a plan or notice; it does not approve a GLP-1 prescription.
Texas SHIP counselingThese are official-program navigation links, not proof of medication coverage. No affiliate commission is earned from these resources.
A carrier name or an “insurance accepted” badge cannot establish your benefit. Use this checklist with your Medicaid plan, Medicare drug plan or private insurer, then keep the response or reference number.
20 of the 36 programs we track publish a service area that includes Texas. The 8 below have the highest editorial scores among those programs. A service-area match does not mean your insurance is accepted or your treatment is approved.
We left out 14 programs with a state caveat or an incomplete service-area list. Confirm your address and prescription at intake before paying.
Some programs are affiliate partners, and we may earn a commission from a referral. Partnership does not change the editorial score. How we score providers.
8/10 editorial score · Both
from $159/mo
Advertised program price, not an insurance copay.
One-month semaglutide plan. The $119/mo rate requires $1,428 upfront for 12 months.
$159/mo buys the one-month semaglutide plan on its pricing page, struck from a $228.60/mo list price. One month of tirzepatide is $249/mo. The advertised floors of $119/mo semaglutide and $179/mo tirzepatide are 12-month plans billed up front, verified 2026-09-03
Full review and sources
7.9/10 editorial score · Brand
published $99/mo; total not verified
Advertised program price, not an insurance copay.
Program fee only. Medication is extra; total not verified.
published month-to-month program fee; medication is separate, medication-inclusive total not verified
Full review and sources
7.8/10 editorial score · Compounded
from $212/mo
Advertised program price, not an insurance copay.
12-month plan rate, billed every 48 weeks; $249 month-to-month. First-order discounts vary.
12-month-plan rate; $249/mo month-to-month, with $50-$100 first-order discounts via on-page SUMMER codes
Full review and sources
7.8/10 editorial score · Both
from $158/mo
Advertised program price, not an insurance copay.
12-month compounded semaglutide plan: $1,900 upfront. Month-to-month is $249.
12-month compounded semaglutide plan: $1,900 upfront. Month-to-month is $249.
Full review and sources
7.8/10 editorial score · Both
from $159/mo
Advertised program price, not an insurance copay.
12-month semaglutide plan rate; $179 on 6 months or $199 month-to-month. Brand medication is extra.
the $159 floor is the 12-month semaglutide plan on the pricing page; 6-month is $179 and month to month is $199, verified 2026-09-03
Full review and sources
7.6/10 editorial score · Both
from $199/mo
Advertised program price, not an insurance copay.
Compounded semaglutide injection; tablets $299. Advertised welcome credit applied at checkout.
the $199 is the compounded semaglutide injection floor on its products page; the oral dissolving tablet is $299. A $100 welcome credit is advertised as applied at checkout with no code needed
Full review and sources
7.5/10 editorial score · Compounded
from $299/mo
Advertised program price, not an insurance copay.
Compounded semaglutide. Product and dose change the price.
$299/mo is a starting program price, not one rate for every product. Willow's current help center pricing article lists compounded semaglutide injections at $299/mo up to 3.5 mg and $399/mo at 7 mg, tirzepatide injections at $399/mo through 6.375 mg then $499/mo at 8.5 and 11 mg, $524/mo at 13.5 mg and $549/mo at 17 mg, semaglutide tablets at $299/mo for all listed dosages, and tirzepatide tablets at $399/mo at 6 and 10 mg and $459/mo at 20 mg. Public price schedule checked September 26, 2026; confirm the prescribed product and current quote.
Full review and sources
7.5/10 editorial score · Compounded
from $167/mo
Advertised program price, not an insurance copay.
Compounded semaglutide injection. Published starting prices differ by page; confirm checkout.
starting price for compounded injectable semaglutide, listed as low as $167 a month with every dose the same price on its product page. Oak quotes different floors elsewhere, from $119 a month in the homepage FAQ up to $250 a month for the oral option, so confirm the figure at checkout
Full review and sourcesAcross 13 compounded programs we track nationally, the median advertised recurring price is $179/mo. This is a national benchmark, not a measured Texas average. A brand-name medicine, different dose or longer commitment can have a different price.
Among programs with published Texas availability and non-intro monthly pricing, advertised amounts start at $99/mo. This is not a verified checkout total. Confirm medication, dose, amount paid upfront, renewal and any additional fees before comparing.
All one publish availability that includes Texas. The Top Pick is the program we feature to start with (an affiliate partner, disclosed); the zero below own one angle each. Read the methodology.
current $149/mo microdose offer is priced on a 3-month subscription; all-doses compounded GLP-1 from $179/mo yearly; Gala's main site lists 3-month GLP-1 plans from $199/mo, with final price confirmed at checkout Recorded 2026-09-25.
Patients comparing Gala's $149/mo microdose on its 3-month promotional offer with the $179/mo yearly all-doses plan, and who will use its free companion app for progress logging
Program details to compare
Texas traditional Medicaid publishes separate Wegovy and Zepbound authorization criteria, revised May 8, 2026. Wegovy has cardiovascular-risk criteria from age 45 and an injection-specific noncirrhotic MASH pathway from age 18. Zepbound's criteria address adults with obesity and moderate-to-severe obstructive sleep apnea. These are indication-specific request routes, not a general weight-loss benefit or guaranteed coverage for every listed product code. The documents explicitly require checking current formulary coverage. Managed-care members should also confirm their plan's implementation. Ask the prescriber to match the diagnosis, formulation, product code and documentation to the relevant current policy. Confirm the exact drug, indication, age criteria and your plan's authorization requirements before paying.
The Medicare GLP-1 Bridge uses federal eligibility rules, not Texas Medicaid's policy. Ordinary Part D coverage depends on your prescription and drug plan; the separate Bridge requires its own eligibility and authorization review. A state Medicaid restriction does not decide your Medicare benefit.
The 8 programs listed below publish a service area that includes Texas. Confirm your address, the exact medication, clinician availability and any pharmacy restrictions at intake. A state listing does not guarantee a prescription or a delivery date.
Our national sample of 13 compounded programs has a median advertised recurring price of $179/mo, with a range of $69 to $299/mo. This is not a measured Texas average, insurance copay or quote for your dose. Compare the medication, billing commitment, renewal price and extra care fees.
Four affiliate partners we feature, we may earn a commission.
Microdose offer on a 3-month subscription. Confirm the full checkout total.
Annual semaglutide plan with code NYNY12; $279 month-to-month.
Affiliate links, we earn a commission at no extra cost to you. These are featured partners, prioritized by our affiliate economics, not an editorial "best" ranking. The objective ranking (by methodology score) and full methodology are at GLP-1 Picks comparison.
