Does Medicare Cover Mounjaro? Part D Rules, the Bridge, Copays
Yes for type 2 diabetes: Medicare Part D plans cover Mounjaro, and about 8 in 10 Part D patients pay $0 to $50 per 28 days. It is not in the $50 GLP-1 Bridge, which is for weight loss.
- Medicare GLP-1 Bridge copay
- $50 a month
- Bridge runs
- July 1, 2026 to December 31, 2027
- Mounjaro in the Bridge
- No
- Part D for weight loss alone
- Not covered
Mounjaro facts at a glance
Its half-life is about 5 days: after 5 d, half is gone, and about 3% remains after five half-lives (25 d).
In the 40-week SURPASS-1 trial for type 2 diabetes, participants lost 7.8 kg compared with 1 kg on placebo.
Monthly prices in US dollars include the list price and self-pay offers, based on the maker's price page.
Sources: FDA label (DailyMed), healthsystemtracker.org, pricinginfo.lilly.com.
Does Medicare cover Mounjaro?
| Medicine | Approved for | Part D covers | In the $50 Bridge |
|---|---|---|---|
| Mounjaro | Type 2 diabetes and heart risk | Diabetes and heart-risk uses | No |
- Under Part D, weight loss alone is not covered
- For diabetes or cardiovascular disease, Part D coverage may apply
- If the drug is for Type 2 diabetes, sleep apnea, or fatty liver, your plan may cover it
Sources: pricinginfo.lilly.com, mounjaro.lilly.com, GoodRx, medicare.gov.
The published policy
- Bridge starts: July 1, 2026
- Bridge ends: December 31, 2027
- The copay under Medicare GLP-1 Bridge is $50 each month
- Foundayo, Wegovy, Zepbound KwikPen are Bridge drugs
- The Bridge does not include vials or single-dose pens
- Part D deductible: Not counted
View the policy directly at medicare.gov.
Sources: humana.com, medicare.gov, CMS.
Prior authorization checklist
- Another approved use of Mounjaro appears in your chart as type 2 diabetes or heart risk.
- Approval for prior authorization
- Records: Your recent A1C results and diabetes drugs you have already tried.
- Your prescriber files the prior authorization, not you.
Source: medicare.gov.
The appeal, if you are denied
| Denial reason | What to send or ask |
|---|---|
| Prior authorization missing | The plan's form is sent by your prescriber with recent A1C results and your type 2 diabetes diagnosis. |
| The plan wants another drug first | Send records showing what you have already tried, and ask which of the drugs the plan wants tried first. |
| The drug is not on the plan's list | Request a formulary exception and learn the plan's preferred alternative, a GLP-1. |
- Ask your Part D plan for a coverage determination, or seek an exception for a drug that is not on its list.
- If the plan turns down your request, ask for a redetermination. Your prescriber can give a supporting statement.
- If the redetermination fails, the appeal goes to an independent reviewer outside the plan.
State and plan differences
Medicare Advantage plans with drug coverage follow the same rules. For every 30-day supply, Humana lists a Bridge copay of $50.
Each Part D plan controls its own drug list and copay tiers, so the copay for diabetes use changes from one plan to another.
Your state's Medicaid rules also apply if you have both Medicare and Medicaid: Does Medicaid Cover Mounjaro? State-by-State Rules and PA.
Source: humana.com.
When coverage says no: other options
| Route | Who it is for | What you pay |
|---|---|---|
| Mounjaro savings offer when your plan offers no coverage | commercial plan without coverage | $499 a month |
Prices checked November 2026. Each price takes you to its source page.
Sources: pricinginfo.lilly.com, mounjaro.lilly.com, GoodRx.