Does Pennsylvania Medicaid
Cover Mounjaro?
Mounjaro (Tirzepatide) coverage, costs, and how to get it in Pennsylvania.
Coverage Status
Mounjaro coverage details for Pennsylvania residents.
Covered for type 2 diabetes diagnosis. Prior authorization typically requires documented A1C levels and trial of metformin.
How to Get Mounjaro Covered
Steps to get Mounjaro covered by your insurance in Pennsylvania.
Talk to your doctor
Ask your doctor to prescribe Mounjaro and confirm it's appropriate for your condition.
Submit prior authorization
Your doctor's office will submit a prior authorization to Pennsylvania Medicaid. This typically takes 3-5 business days.
Check patient assistance
If coverage is denied, check Eli Lilly's patient assistance program for free or reduced-cost options.
Appeal if needed
You can appeal a coverage denial through Pennsylvania Medicaid. Your doctor can provide supporting documentation.
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Mounjaro Side Effects
Common and serious side effects to discuss with your doctor.
⚡ Common Side Effects
- Nauseacommon
- Diarrheacommon
- Decreased appetitecommon
- Vomitingcommon
- Constipationcommon
⚠️ Serious Side Effects
- Pancreatitisrare
- Thyroid tumorsrare
Seek immediate medical attention if you experience any serious side effects.
Monitor Side Effects
Track Mounjaro Side Effects with Helix
Oura-style monitoring for your Mounjaro journey. Log side effects, see trends over time, and share reports with your doctor.
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Track Your Mounjaro Journey
Meet Enzo — Your GLP-1 Companion
A virtual pet that grows as you track your Mounjaro doses, weight, and meals. Stay motivated with streaks, milestones, and a buddy who celebrates your progress.
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Frequently Asked Questions
Does Pennsylvania Medicaid cover Mounjaro?
Pennsylvania Medicaid covered (prior auth) Mounjaro. Prior authorization is required. Covered for type 2 diabetes diagnosis. Prior authorization typically requires documented A1C levels and trial of metformin.
How much does Mounjaro cost in Pennsylvania?
Without insurance, Mounjaro costs approximately $1,023/month. With Pennsylvania Medicaid, your copay may be $0-$25.
How do I get Mounjaro covered in Pennsylvania?
Contact your Pennsylvania Medicaid office or insurance provider to check coverage. Your doctor will need to submit a prior authorization request.
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Mounjaro in Other States
Other GLP-1 Medications in Pennsylvania
Weekly GLP-1 injection for type 2 diabetes and weight management
Wegovy in PennsylvaniaFDA-approved weekly injection for chronic weight management
Zepbound in PennsylvaniaFDA-approved dual-action injection for chronic weight management
Saxenda in PennsylvaniaDaily GLP-1 injection for weight management
Rybelsus in PennsylvaniaFirst oral GLP-1 tablet for type 2 diabetes
Trulicity in PennsylvaniaWeekly GLP-1 injection for type 2 diabetes
Victoza in PennsylvaniaDaily GLP-1 injection for type 2 diabetes