Will my insurance cover Mounjaro (tirzepatide) for insulin resistance?

**Prior authorization is usually required**: Insurance providers typically require prior authorization before covering Mounjaro for insulin resistance, even if the medication is prescribed for weight management and improving hyperglycemia.

**Insurance coverage varies widely**: Coverage for Mounjaro varies depending on the insurance provider, plan type, and individual coverage details, so it's essential to review your plan's coverage details.

**Medicare Part D and commercial plans often cover Mounjaro**: Many major insurance plans, including Medicare Part D and commercial plans, cover Mounjaro for insulin resistance when used as prescribed for weight management and improving hyperglycemia.

**High-deductible plans may require significant out-of-pocket costs**: Some insurance plans, particularly high-deductible plans, may require patients to pay a significant amount out-of-pocket before coverage kicks in.

**Specific criteria may be required for coverage**: Insurance plans may have specific criteria that must be met for coverage, such as proof of failed attempts with other medications or lifestyle modifications.

**The Mounjaro Savings Card can lower costs**: The manufacturer of Mounjaro offers a savings card that can lower the cost to $25 for up to a 3-month supply if you have commercial prescription insurance.

**BCBS coverage depends on the specific plan**: BCBS (Blue Cross Blue Shield) may cover Mounjaro, but it depends on the specific plan, with some plans listing it as a preferred drug and others as non-preferred.

**Without insurance, Mounjaro costs around $1,474 per month**: The average monthly cost of Mounjaro without insurance is between $1,000 to $1,200, depending on the pharmacy.

**The Mounjaro Savings Card can save up to $573**: If your commercial insurance doesn't cover Mounjaro, you can still benefit from the Mounjaro Savings Card, which can save up to $573 for a 1-month prescription.

**Insurance coverage for Ozempic varies**: Insurance coverage for Ozempic (semaglutide) for insulin resistance also varies, and the cost can be a significant barrier to treatment.

**Ozempic retail prices range from $1,000 to $1,200**: The retail price of Ozempic ranges from $1,000 to $1,200 or more for one pen, depending on the pharmacy.

**FDA approval was given in May 2022**: Mounjaro was approved by the US Food and Drug Administration in May 2022 and was expected to go on sale by the end of June 2022.