State coverage
South Carolina
Medicaid, for obesity: Does not cover. The conditions and the appeal deadline are in the summary below.
At a glance
- Medicaid, for obesity
- Removed GLP-1s for obesity from its drug list on December 31, 2025. Wegovy survives for heart and liver.
- Appeal deadline
- 30 calendar days following receipt of the notice, by postmark. 10 days from the date on the notice to keep services running source
- Date read
- September 2026
South Carolina stopped covering GLP-1s for obesity at the end of 2025, and the way you can tell is unusual enough to be worth explaining.
There is no provider bulletin announcing it. The state's own record of the decision is a line in the minutes of its Pharmacy and Therapeutics Committee, where a state medical director told the committee the drugs would come off the drug list and gave the date. That is a real, dated, state-published document — it is just not where most people would look.
The drug list itself corroborates it. The edition in force at the start of 2026 carries a weight management class with Wegovy in it; the next edition published does not carry that class at all, and neither does the one in force now. The diabetes GLP-1s stayed exactly where they were, which is how you can tell the class was removed rather than the document reorganized.
What survives is narrow and specific, and the minutes say so: Wegovy remains covered for indications other than obesity, and someone already taking it for one of those may need a fresh prior authorization to keep it.
What we could verify for South Carolina
The state's own record of the decision is in its P&T Committee minutes, under State Updates: "Dr. Wessinger notified committee members that GLP-1 medications for obesity would be removed from the PDL 12/31/2025. There will be no changes to GLP-1 products with respect to the indication for diabetes. Wegovy will continue to be covered for indications other than obesity (e.g., MACE/MASH). If members are currently taking Wegovy for these indications, they may require a new Prior Authorization for those indications." The minutes are headed November 5, 2025.
South Carolina Department of Health and Human Services, Pharmacy and Therapeutics Committee Meeting Minutes, effective November 2025 · source
The drug list in force at the start of 2026 still carried the class. Under the headings "WEIGHT MANAGEMENT AGENTS" and "INJECTABLE GLP-1 AGENTS" it stated "Clinical Criteria applies to all drugs in this class", listed "Wegovy® Injection" as preferred, and listed "liragtutide injection (generic for Saxenda®)" and "Saxenda® Injection" as non-preferred. The edition's face reads "Effective Date: 01/01/2026". (The misspelling of liraglutide is the document's own.)
South Carolina Healthy Connections Medicaid, Single Preferred Drug List, effective 01/01/2026, effective January 2026 · source
The class is gone from the list in force now, and the diabetes drugs are untouched — which is how we know the class was removed rather than renamed. Searching the edition whose face reads "Effective Date: 09/01/2026", the strings "WEIGHT MANAGEMENT AGENTS", "INJECTABLE GLP-1 AGENTS", "Wegovy" and "Saxenda" each appear zero times, while "Ozempic" appears once, "Mounjaro" once and "insulin" twelve times — the identical control counts those three return in the January edition, where Wegovy and Saxenda were present.
South Carolina Healthy Connections Medicaid, Single Preferred Drug List, effective 09/01/2026, effective September 2026 · source
The current GLP-1 criteria are now a diabetes document. The state's "GLP-1 Receptor Agonists and GLP-1/GIP Receptor Agonists Criteria", stamped "Revised 05/01/2026", runs to about 2,900 characters and contains no occurrence of "weight", "obes", "BMI", "Wegovy", "Saxenda" or "Zepbound", against control counts of three for "diabetes" and two for "Ozempic".
South Carolina Healthy Connections Medicaid, GLP-1 Receptor Agonists and GLP-1/GIP Receptor Agonists Criteria, effective May 2026 · source
A separate and older exclusion sits underneath all of this, and it is absolute on its face. The Pharmacy Services Provider Manual dated JULY 1, 2026 lists, under "NON-COVERED SERVICES AND DEFINITIONS", products "excluded from Healthy Connections coverage" that "are considered non-covered, regardless of circumstance", and the first bullet is "Weight control products".
South Carolina Department of Health and Human Services, Pharmacy Services Provider Manual, effective July 2026 · source
South Carolina did not announce this in a provider bulletin, and we checked the whole archive rather than assuming. We recovered every bulletin link from all 36 pages of the department's communications listing — 364 unique bulletins — and none of their addresses contains weight, obes, GLP, Wegovy, Saxenda, Zepbound, Mounjaro, Ozempic, semaglut, tirzepat or liraglut. The same census returns 26 bulletins matching "pdl", "pharmac" or "drug", so the search was working. The P&T minutes above are the announcement.
South Carolina Department of Health and Human Services, Medicaid bulletins archive · source
Two different clocks run after a denial and the shorter one is the one that keeps your drug coming. The department states that "A request for a fair hearing by mail is considered filed if postmarked by the 30 calendar day following receipt of this notification", and separately that "You may also request continued benefits or services if you request continued services within 10 days of the date on the notice." It adds that "Ordinarily, member appeals should be concluded within 90 days of filing" — a decision timeline, not a filing deadline.
South Carolina Department of Health and Human Services, File an Appeal · source
Medicaid is only one of the routes. If you have a commercial or employer plan, the rules are different and are on the employer plans page; Medicare has a federal rule of its own, on the Part D page.
If the appeal fails, or you cannot wait
Cash-pay telehealth is the fallback, not the bargain: you pay the whole cost yourself, and a covered prescription is almost always cheaper than any of these. Use this route when coverage has actually been exhausted, or when you need to start while an appeal runs.
These companies pay us a commission if you start care through the links below. That is how this site is funded, and it does not change what is written above. How we pay for this.
- CoreAge RxAdvertises $99 a month for compounded semaglutide, flat across doses. Read the terms before you sign up: the lander our link opens has shown $149 rather than $99, and a consultation fee can be charged on top and may not be refundable.
- OakFlat price across doses, free shipping with supplies.
- Care Bare RxNames its pharmacies with addresses; sells brand Ozempic as well as compounded.
- Gala HealthAll doses one price, but the advertised rate needs a yearly subscription.
- Synergy RxProviders licensed in your state; publishes no GLP-1 price before the consult.
- Breeze MedsServes all 50 states; publishes a starting price only.
Prices in those notes were read from each company's own site in August 2026 and change often. Check the current number before you buy.
Where this comes from
- South Carolina Department of Health and Human Services, Pharmacy and Therapeutics Committee Meeting Minutes, effective November 2025 — southcarolina.fhsc.com/downloads/provider/PTMinutes_20251105.pdf
- South Carolina Healthy Connections Medicaid, Single Preferred Drug List, effective 01/01/2026, effective January 2026 — southcarolina.fhsc.com/downloads/provider/SCpdl_listing_20260101.pdf
- South Carolina Healthy Connections Medicaid, Single Preferred Drug List, effective 09/01/2026, effective September 2026 — southcarolina.fhsc.com/downloads/provider/SCpdl_listing_20260901.pdf
- South Carolina Healthy Connections Medicaid, GLP-1 Receptor Agonists and GLP-1/GIP Receptor Agonists Criteria, effective May 2026 — southcarolina.fhsc.com/downloads/provider/SCRx_PAcriteria_GLP1s.pdf
- South Carolina Department of Health and Human Services, Pharmacy Services Provider Manual, effective July 2026 — provider.scdhhs.gov/internet/pdf/manuals/pharm/Manual.pdf
- South Carolina Department of Health and Human Services, Medicaid bulletins archive — www.scdhhs.gov/communications
- South Carolina Department of Health and Human Services, File an Appeal — www.scdhhs.gov/appeals/file-appeal
Every state we have verified is in the coverage matrix. Appeal routes and deadlines are on the procedures page.