Medicaid Coverage in NY
Hey there, my name is Conner and I've been fighting my Medicaid insurance for almost 4 years at this point. I've seen several different doctors and I have seen zero progress from my insurance. I call and try to appeal things but they tell me they can't help me. I am 550 pounds with significant pain that limits my exercise severely. I have tried Noom and weight watchers, counting calories, and even intermittent fasting, but nothing has been helpful. I was wondering if anyone had any advice on getting zepbound covered by Medicaid. I have a new PCP and they have been trying to help me, as well as a medication assisted weight loss professional, but neither of them have been able to make any progress. I fear that this is my only opportunity to help me lose weight besides getting surgery, which I would like to avoid. I do have Obstructive sleep apnea as well, I should have mentioned.
As of July 16th of 2026, the NYRX PDL lists zepbound as something they will cover for those who have OSA and a bmi over 40, which I do, but every time I call and try to make my case, they read off their script that It isnt covered and they cant help me
Any advice on how to proceed would be amazing. I worry about my health. Every day I worry I'm going to have a heart attack, and every day, I'm getting weaker and in more pain. Any help would be greatly GREATLY appreciated, as im feeling hopeless about ever getting zepbound.