Does Medicaid cover Mounjaro?
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MassHealth lists Mounjaro as a preferred GIP/GLP-1 drug for diabetes, and California Medi-Cal keeps Mounjaro on its drug list restricted to type 2 diabetes. Neither covers it for weight loss.
What Medicaid specifically requires
Sources: MassHealth Pharmacy Facts #271: anti-obesity medications (Mar 12, 2026); Anthem Blue Cross (Medi-Cal): GLP-1 Coverage Considerations (Nov 14, 2025)
About Medicaid coverage
- KFF: 13 state Medicaid programs covered GLP-1s for obesity in fee-for-service as of January 2026, down from 16 in October 2025. California, New Hampshire, Pennsylvania and South Carolina ended coverage. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
- North Carolina ended Medicaid GLP-1 obesity coverage in October 2025 and reinstated it in December 2025. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
- MassHealth ended coverage of drugs used for weight loss, including Wegovy, Zepbound and Saxenda, on July 3, 2026. Coverage continues with prior authorization for cardiovascular disease, MASH and sleep apnea. MassHealth Pharmacy Facts #271: anti-obesity medications, Mar 12, 2026
- California Medi-Cal removed Wegovy, Zepbound and Saxenda from its drug list for weight loss on January 1, 2026; members under 21 are reviewed under EPSDT. Anthem Blue Cross (Medi-Cal): GLP-1 Coverage Considerations, Nov 14, 2025
- CMS announced the BALANCE model in December 2025, a voluntary program to negotiate lower GLP-1 prices for Medicaid and Medicare. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
Where to get Mounjaro
Telehealth services that handle Mounjaro, useful while prior auth processes or as a cash-pay alternative. We may earn a commission. See disclosure.
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Ro Body, branded GLP-1 weight care program
Medicaid not the right plan?
Coverage varies between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 20 US insurers and programs, or run the insurance pre-check to estimate your specific plan's odds.
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Frequently asked
Does Medicaid cover Mounjaro?+
MassHealth lists Mounjaro as a preferred GIP/GLP-1 drug for diabetes, and California Medi-Cal keeps Mounjaro on its drug list restricted to type 2 diabetes. Neither covers it for weight loss.
Does Medicaid require prior authorization for Mounjaro?+
Yes. Medicaid requires prior authorization for Mounjaro. Your prescriber submits the request with the documentation listed in the Medicaid criteria on this page.