Is Mounjaro covered by insurance or Medicare?

Your insurance company may cover your prescription for Mounjaro, but this will vary based on the insurance plan and drug benefits. The manufacturer of Mounjaro offers a savings card that can lower your cost to $25 for up to a 3-month supply, if you have commercial prescription insurance coverage.

You can download the coupon directly to your computer or phone and use it for up to 13 refills per calendar year.

To find out if your drug plan will pay for Mounjaro, contact them and ask if Mounjaro is on their formulary (the list of the drugs they have approved for coverage) and which conditions it covers. Your prescription plan may cover Mounjaro for treatment of type 2 diabetes, its FDA-approved use, but not for weight loss, which is an "off-label" use.

Patients covered under government insurance such as Medicare, Medicaid, Medicare Part D, Medigap, DoD, VA, TriCare/Champus, or any state or pharmaceutical assistance program do not qualify for the $25 savings card.

Mounjaro $25 Coupon

Eli Lilly the manufacturer of Mounjaro offers a $25 Savings Card that can lower your cost to a $25 for up to a 3-month supply, if you have commercial prescription insurance and a documented diagnosis of type 2 diabetes. A month is equal to 28-days and up to 4 pens, and 3 months is 84 days and up to 12 pens.

Click here for the coupon link: Mounjaro Price Guide and Savings Coupons You can also call call Eli Lilly at 1-844-805-5807.

With the card, you could save up to $150 per 1-month prescription fill, $300 per 2-month prescription fill, or $450 per 3-month prescription fill with maximum copay savings of $1800 per calendar year.

The amount you pay for Mounjaro will depend upon your prescription drug coverage, deductible and copay (determined by the “tier”). Higher tiers, like tier 3 or 4, usually mean higher copays.

If you have not fully met your yearly deductible, or if the drug is not covered, you may be responsible for the full monthly cost of this drug which may be over $1,000 per month. Coverages and costs will vary among plans.

How do I get the Mounjaro savings card if my insurance won't cover it?

Eli Lilly, the manufacturer of Mounjaro offers a savings card program for eligible patients with commercial prescription drug insurance, even if your insurance plan does NOT cover Mounjaro. Commercial insurance is the type often offered through your employer or that you buy on your own, for example through the Health Insurance Marketplace.

You may be able to obtain savings of up to $473 per month off your 1-month prescription fill of Mounjaro if you have commercial insurance but your drug plan does not cover Mounjaro. One month is defined as 28-days and up to 4 pens. Card savings are subject to a maximum annual savings of up to $2,365 per calendar year. You can use your card for 5 prescription refills per calendar year.

If you have type 2 diabetes and are an adult resident of the U.S., you may be able to save money with Mounjaro by using this savings card. You can obtain and activate the savings card on the Mounjaro website before you use it, or you can call Eli Lilly at 1-844-805-5807.

If you do not have prescription insurance or you have government-sponsored insurance (such as Medicare, Medicaid, Medicare Part D, Medigap, DoD, VA, TriCare/Champus, or any state or pharmaceutical assistance program), you are not eligible for the $25 Mounjaro prescription drug savings card.

If you do not have commercial insurance but need assistance you can call The Lilly Answers Center at 1-800-LillyRx (1-800-545-5979) for information on other types of affordability solutions.

How long does the Mounjaro savings card last?

You can use the Mounjaro savings card until Dec. 31, 2024.

If you have questions about how to save money on your Mounjaro prescription, or for other questions, you can contact the Mounjaro patient services support center at 1-844-805-5807.

When will insurance pay for Mounjaro?

If your insurance pays for Mounjaro, it will typically only be paid for when it is prescribed for its FDA-approved indication, type 2 diabetes in adults.

Mounjaro is not approved as a weight loss medication, and insurance companies will not typically cover Mounjaro for this use, even if your doctor writes you a prescription for weight loss (known as an “off-label” indication).

Can I used Zepbound instead of Mounjaro?

If your doctor agrees, Zepbound may be a good option for you if it has been decided that you should be treated with a GLP-1 agonist for weight loss.

If your doctor prescribes Mounjaro for weight loss, but it is not covered for this use, speak with your doctor about using Zepbound. Zepbound, which contains tirzepatide (the same active ingredient as Mounjaro) has been approved for weight loss maintenance in adults. Also, check with your prescription plan to determine if you have insurance coverage for this medication, if needed for weight loss.

Other FDA-approved options similar to Mounjaro are available for use in weight loss.

• Wegovy (generic name: semaglutide) is an FDA-approved for the weight loss that is similar to, but not exactly the same as Mounjaro.
• Semaglutide is also sold under the brand names Ozempic and Rybelsus for the treatment of type 2 diabetes in the U.S., but are not approved by the FDA for weight loss.

Related questions

• Mounjaro vs Ozempic: Which is right for you?
• Ozempic Side Effects to Watch For
• Zepbound Vs Mounjaro: Complete Comparison Guide for Weight Loss and Diabetes Treatment

How do I get insurance to cover Mounjaro?

If your doctor agrees Mounjaro is right for you, and your insurance pays for Mounjaro, you may be required to follow a “stepped therapy” plan for type 2 diabetes treatment before you are eligible for coverage. The specifics for these plans may vary among insurance companies.

Drug plans may require that you have previously had an inadequate response to several different types of 2 diabetes treatments (this is called “stepped therapy”), or experienced intolerable side effects, before you are eligible for payment for Mounjaro treatment.

Your doctor may need to fill out a “prior authorization” form, which is paperwork submitted to the insurance company to determine your eligibility for Mounjaro. It can take several days or longer to hear back on the decision.

How much does one month of Mounjaro cost?

The retail cash price for Mounjaro is about $1,135 for a one month (28-day) supply of Mounjaro (equal to four pens) as of Sept 2, 2024, but most people do not pay this price. The price you pay is dependent on your insurance coverage, deductibles and copays.

The manufacturer may be able to offer a $25 savings card or other patient financial assistance, if you qualify. Online discount coupons may also help you save if you are paying cash.

Which insurance covers Mounjaro?

Prescription drug coverages vary among insurance plans.

Your drug plan can tell you if Mounjaro is covered under your benefits. Call your insurance and ask if Mounjaro is on their formulary and which medical conditions it covers. You can usually find the number to call on the back of your card.

Eli Lilly, the manufacturer of Mounjaro offers a copay card program for patients with commercial prescription drug insurance who qualify, even if their insurance plan does not cover Mounjaro. You may pay as little as $25 for up to a 3-month supply. Contact the Mounjaro patient services support center at 1-844-805-5807 to learn more.

If you have state or federal government-sponsored prescription insurance, for example, Medicare Part D, Medicaid, TriCare of DOD, contact your plan to determine your eligibility for Mounjaro.

What is Mounjaro?

Mounjaro (tirzepatide) is a medicine approved by the FDA in May 2022 to help lower blood sugar (glucose) in adult patients with type 2 diabetes. It is used in addition to a weight-loss diet and exercise plan.

Mounjaro is not approved as a weight loss medication, but it may help you lose weight if you have type 2 diabetes. It is given as a weekly subcutaneous (under the skin) injection. You, or a caregiver, can learn to administer this medicine for home use.

Learn more: Does Mounjaro work for weight loss?

Is Mounjaro available as a generic?

No, Mounjaro (generic name: tirzepatide) was first approved in 2022 and a generic option is not expected before 2036.

Mounjaro is an expensive injectable medicine used weekly to help lower blood sugar levels in adults with type 2 diabetes, but a copay savings card or coupon may help to lower your costs, if you have commercial drug insurance.

If you have further questions about how to save on your Mounjaro prescription, contact the Mounjaro patient services support center at 1-844-805-5807.

This is not all the information you need to know about Mounjaro (tirzepatide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.