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This means that even if your plan provides coverage for this medicine, your healthcare provider will likely need to submit a prior authorization (PA) —documentation explaining why you need this medication. For example, some plans may cover a three-month supply, while others may approve a one-month supply with each prescriptionfill.
Mounjaro (tirzepatide) is an injectable medication prescribed for Type 2 diabetes mellitus, which some doctors may prescribe off-label for weight loss. That price could depend on where you get your Mounjaro prescriptionfilled, though. Mounjaro’s only on-label use is for diabetes, so Medicaid likely won’t cover it for obesity.
Health insurance plans generally don’t cover Mounjaro for weight loss, as this would be an off-label use. Look at your insurance plan’s formulary One of the first things you can do to check coverage for medications is check your plan’s formulary or prescription drug list. Search for Mounjaro in the list to see its coverage status.
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