The Cost of Mounjaro – and How You Can Save With Coupons, Savings Cards, Alternatives, and More

GoodRx Health

Mounjaro (tirzepatide) has grown in popularity since it was FDA-approved for Type 2 diabetes in 2022. The medication can cost over $1,000 per month, but your health insurance may cover Mounjaro if it's prescribed for Type 2 diabetes.

Tirzepatide has also been linked to significant weight loss. If you take Mounjaro for this reason, you may have to pay out of pocket. Another medication, Zepbound (tirzepatide), was created by the manufacturer of Mounjaro, Eli Lilly, under a new name for weight loss purposes. It was approved by the FDA for chronic weight management in November 2023.

Whether your insurance covers Mounjaro - or you don't have insurance at all - there are still ways to save money on the medication.

How much does Mounjaro cost?

The list price of Mounjaro is $1,069.08 per fill. Without insurance, you could pay a retail price anywhere from $1,000 to $1,200 or more per month. Each fill has 4 prefilled pens, amounting to a 28-day supply.

The price you pay for Mounjaro can vary depending on various factors, including:

• Where you live

• The pharmacy you choose

• The reason your healthcare professional prescribed the medication

• Whether you have insurance

Your costs for Mounjaro will likely be ongoing since the medication is intended for long-term use.

How to save money on Mounjaro

Mounjaro is only available as a brand-name medication, so there aren't any lower-cost generic versions available. But there are still ways to save money on your prescription. Here are eight options to consider.

1. Get a free Mounjaro coupon from GoodRx

GoodRx offers coupons for a wide range of medications, including Mounjaro. If you have insurance, check to see if you can get a better deal on your medication by using a GoodRx coupon.

You can download your free coupon by doing the following:

• Download the GoodRx app or visit www.goodrx.com.

• Search for Mounjaro.

• Text, print, or email your coupon.

2. Find out if your health insurance plan covers Mounjaro

Some health insurance plans may cover Mounjaro for Type 2 diabetes, since it was FDA-approved for that purpose. However, your plan may not cover it for an off-label use such as weight loss. Your plan may, however, cover Zepbound for that purpose.

It's important to review your insurance plan to see if Mounjaro is covered and if there are any rules that can limit your coverage.

Here's how to determine if your health insurance plan covers Mounjaro:

• Check your formulary. Your health plan's medication formulary shows what brand-name and generic medications are covered. Medications are categorized into tiers, and those in higher tiers tend to cost more. You can see if Mounjaro is included in your formulary by contacting customer service or going to your health insurer's website.

• Review restrictions. Some medications, including Mounjaro, may require step therapy or a prior authorization before you can receive coverage.

• Understand how your specific health plan works. Employer-sponsored health insurance plans may cover Mounjaro for Type 2 diabetes, depending on your employer. But if you have Medicare, it won't cover Mounjaro or Zepbound if they're used for weight loss, because the Medicare Prescription Drug, Improvement, and Modernization Act prohibits it.

With insurance, your out-of-pocket costs for Mounjaro will depend on your coverage, formulary, deductible, and copay.

3. Get Mounjaro covered by insurance through an exception

Not all medications that you need may be covered under your health plan's formulary. If your insurance plan doesn't cover Mounjaro, you can ask the plan to make an exception and cover a medication that is not listed in its formulary.

Here are a few steps to start the process:

• Contact your insurance provider. Find out your insurance plan's process for requesting a formulary exception. They can guide you through the steps to get started.

• Gather required documentation. Your healthcare professional may need to submit a statement, such as a letter of medical necessity, that shows why you need Mounjaro for your specific condition.

• Submit the request. Your insurance company may require you to fill out a request form, in addition to providing supporting documentation.

If your request is approved, your insurance plan will cover Mounjaro. If not, you can consider writing an appeal letter to your health insurance provider.

4. Ask about Mounjaro alternatives

If your insurance company doesn't cover Mounjaro, you can ask your healthcare professional about similar medications that your insurance plan does cover. That way, you won't have to pay for the medication entirely out of pocket, and you can still get the treatment you need.

If you're looking for medications that are similar to Mounjaro, check out the following alternatives for Type 2 diabetes or weight loss.

5. Apply for a Mounjaro Savings Card

If you're eligible for the Mounjaro Savings Card, you could pay as little as $25 for a 1-month or 3-month prescription. You must have commercial insurance and a prescription consistent with FDA-approved product labeling, but your plan doesn't necessarily have to cover the medication.

To qualify for the Mounjaro Savings Card, you must meet certain requirements, including:

• Be enrolled in a commercial medication insurance plan

• Receive a prescription for Mounjaro that aligns with FDA-approved product labeling

• Be a resident of the U.S. or Puerto Rico

• Be at least 18 years old

• Not be enrolled in Medicare, Medicaid, or other government-funded healthcare programs

The requirements for the Mounjaro Savings Card can change at any time. It's important to review the website for the latest information. But if you qualify, here are the savings you can get with your insurance.

With a 1-month supply of Mounjaro, you'll receive 4 pens. Every month's supply is equal to 28 days. For example, if you purchase a 1-month supply, you can save up to $150 per prescription and receive 4 pens. Your savings on Mounjaro is capped at $1,800 per calendar year. The card may be used for up to 13 prescription fills per calendar year if your commercial drug insurance covers Mounjaro.

If your insurance doesn't cover Mounjaro, you can still benefit from the Mounjaro Savings Card. You can receive savings of up to $573 for a 1-month prescription. There's a separate limit of $3,438 in savings per calendar year. The card may be used for up to six prescription fills per calendar year.

6. Compare prices at different pharmacies

Medication prices vary at different pharmacies. Shop around for the best price, as you would any other item on your shopping list.

With GoodRx, you can compare prices at different pharmacies in your area. If you type "Mounjaro" into the search bar on the GoodRx website or app, you'll notice different prices at different locations. Even if you've gone to the same pharmacy for years, you may find another pharmacy in your region that offers the medication you need for a lower price.

7. Ask about free samples of Mounjaro

Pharmaceutical companies often provide samples of medication to healthcare professionals. During your visit, you can ask about free samples of Mounjaro. Trying the medication this way will give you a better idea of how it may affect you before you purchase it.

If your prescriber doesn't have any samples on hand, they may be able to request some from the manufacturer. Eli Lilly, the manufacturer of Mounjaro, provides a request form on its website. Only prescribing healthcare professionals may request samples.

8. Find out if you can receive a 90-day supply of Mounjaro

Some pharmacies may offer special pricing or discounts when you buy a 90-day supply instead of a 30-day supply of medication. You may also have lower copayments.

While getting a larger quantity of your medication may help you save money, make sure your insurance covers it. In addition, verify whether you're subject to prescription refill rules related to your location and/or type of medication.

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GoodRx Holdings Inc. published this content on 02 July 2024 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 02 July 2024 17:02:11 UTC.