Does Medicare cover Mounjaro?
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Part D plans cover Mounjaro for type 2 diabetes; tier and prior authorization depend on your plan's formulary. People with type 2 diabetes get GLP-1s through their Part D plan and cannot use the Medicare GLP-1 Bridge.
What Medicare specifically requires
Sources: Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge (Jun 2026); CMS: Medicare GLP-1 Bridge information for providers (Aug 6, 2026)
About Medicare coverage
- Medicare GLP-1 Bridge: $50 per month for Wegovy (injection or tablet), Zepbound KwikPen or Foundayo, from July 1, 2026 through December 31, 2027. Zepbound single-dose pens and vials are not covered. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- Bridge eligibility: age 18 or older and BMI 35 or more; or BMI 30 or more with HFpEF, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher; or BMI 27 or more with prediabetes, a prior heart attack, stroke or peripheral artery disease. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- The $50 Bridge copay does not count toward the Part D deductible or the yearly out-of-pocket limit. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- People with type 2 diabetes, moderate-to-severe sleep apnea or noncirrhotic MASH get GLP-1s through their Part D plan, not the Bridge. CMS: Medicare GLP-1 Bridge information for providers, Aug 6, 2026
- Federal law lets drug plans exclude agents used for weight loss, hair growth, or erectile dysfunction (42 U.S.C. 1396r-8(d)(2)). 42 U.S.C. 1396r-8(d)(2): drugs that may be excluded or restricted, Current code
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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Medicare 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 Medicare cover Mounjaro?+
Part D plans cover Mounjaro for type 2 diabetes; tier and prior authorization depend on your plan's formulary. People with type 2 diabetes get GLP-1s through their Part D plan and cannot use the Medicare GLP-1 Bridge.
Does Medicare require prior authorization for Mounjaro?+
Yes. Medicare requires prior authorization for Mounjaro. Your prescriber submits the request with the documentation listed in the Medicare criteria on this page.