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Medicaid PA requirements are often stricter than commercial insurance: Typical Medicaid PA Criteria Documentation Checklist Before your doctor submits a Medicaid PA request, ensure these are documented: Required Documentation Current height and weight (measured within the last 30 days) BMI calculation documented by your doctor Diagnosis of obesity or weight-related conditions your doctor should have these on file: Obesity (mild, moderate, or severe) High blood pressure Type 2 diabetes High cholesterol Sleep apnea 6+ months of diet and exercise efforts notes from doctor visits, dietitian referrals, or gym membership records Previous weight loss attempts what you've tried before and why it didn't work long-term Documentation That Strengthens Your Case Weight history showing obesity over the past 2-3 years Records of past weight loss medications you've tried (and the results) Recent lab workblood sugar (A1C, a 3-month blood sugar average), cholesterol panel Sleep study results if you've been tested for sleep apnea Notes about how your weight affects your daily life (difficulty walking, joint pain, etc.) Any hospital or ER visits related to weight complications For complete PA preparation guidance, see our Wegovy prior authorization guide

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