How much does Mounjaro cost? Navigating prices, insurance & savings

Key Points

• The average list price for Mounjaro® is around $1,080 for a month's supply, but your out-of-pocket cost can vary significantly.
• Insurance coverage for Mounjaro often depends on whether it's prescribed for its FDA-approved use (type 2 diabetes) rather than off-label for weight loss.
• Options like discount cards, pharmacy comparisons, and patient assistance programs can help reduce costs for those without insurance or who don't qualify for the savings card.

Mounjaro® (tirzepatide) has captured a lot of attention for its potential benefits in managing type 2 diabetes and supporting weight loss. If you or a loved one are considering this medication, it's natural to wonder about the financial side of things. How much does Mounjaro cost? Will your insurance cover it? What if it doesn't?

Navigating prescription drug prices can feel confusing, especially with new medications, when coverage can vary significantly. Today, we’ll break down everything you need to know about Mounjaro's cost, how insurance plays a role, and practical ways you might be able to save money.

Understanding Mounjaro: How it works (& how it’s approved)

First, let's quickly touch on what Mounjaro is. Mounjaro is a prescription medication that works by mimicking two natural hormones in your body: GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). These hormones help manage your blood sugar levels, slow digestion, and reduce appetite.

Mounjaro is specifically FDA-approved to improve blood sugar control in adults with type 2 diabetes. While many people using Mounjaro have experienced significant weight loss, it's important to know that it's often prescribed off-label for this purpose.

However, there's another medication with the exact same active ingredient, tirzepatide: Zepbound. Zepbound is specifically FDA-approved for chronic weight management. This distinction between Mounjaro and Zepbound often plays a big role in insurance coverage, which we'll discuss next.

How much does Mounjaro cost without insurance?

If you don't have insurance or if your plan doesn't cover Mounjaro, you can expect to pay the full cash price. The manufacturer, Eli Lilly, lists the price of Mounjaro at approximately $1,080 per fill. A "fill" typically includes four pre-filled pens, which is a one-month supply if taken weekly.

Retail prices at pharmacies can vary slightly due to location and other factors, but without insurance, the average monthly cost of Mounjaro generally falls between $1,000 and $1,200. Some sources report that this price can even reach around $1,481 for a 28-day supply without insurance. Annually, paying out-of-pocket could amount to over $12,900.

Does insurance cover Mounjaro?

The cost of Mounjaro changes significantly if you have health insurance. However, whether your insurance covers it and how much you'll pay depends on several factors.

Most health insurance plans, including many Medicare prescription drug plans (Part D and Medicare Advantage), typically cover Mounjaro when it's prescribed for its FDA-approved indication: type 2 diabetes.

However, if your doctor prescribes Mounjaro off-label for weight loss, insurance companies are generally unlikely to cover the cost. This can be incredibly frustrating if you're relying on the medication for weight management.

Even if your plan covers Mounjaro for type 2 diabetes, your specific out-of-pocket costs will depend on your plan's formulary (its list of covered medications), your deductible, and your co-pays. The higher the tier your medication falls into, the more you generally have to pay. It's always a good idea to contact your insurance provider directly to understand your specific benefits and any requirements, like prior authorization.

Why the difference in coverage for weight loss?

The main reason for this difference in coverage boils down to FDA approval. Insurance companies primarily cover medications for their FDA-approved uses. Since Mounjaro is approved for type 2 diabetes, that's where coverage is most consistent. For weight loss, the FDA-approved medication with the same active ingredient is Zepbound.

If your primary goal is weight loss, discussing Zepbound with your healthcare provider might be a valuable step. Because it's specifically approved for chronic weight management, your insurance may be more likely to cover Zepbound for this purpose.

Ways to save on Mounjaro

Even with the high list price, several avenues exist to help make Mounjaro more affordable.

The Mounjaro Savings Card

Eli Lilly, the manufacturer of Mounjaro, offers a Mounjaro Savings Card that can significantly reduce your out-of-pocket costs. For eligible commercially insured patients with Mounjaro coverage, you could pay as little as $25 for a 1-month or 3-month prescription.

However, eligibility is specific:

• You must have commercial drug insurance that covers Mounjaro.
• You need a prescription for an FDA-approved use (i.e., type 2 diabetes).
• You must be a resident of the U.S. or Puerto Rico and be 18 years of age or older.
• You cannot be enrolled in any government-funded healthcare programs like Medicaid, Medicare (including Part D and Advantage plans), or other state prescription drug assistance programs.

It's also important to note that these savings cards have maximum annual limits and expiration dates, which can change. For example, savings might be capped at $1,950 per calendar year if your insurance covers Mounjaro.

What if you don't qualify for the Savings Card?

Don't lose hope if the Mounjaro Savings Card isn't an option for you. There are still other ways to pursue savings.

Other manufacturer programs

While Mounjaro itself may not currently be included in all patient assistance programs, such as Lilly Cares (Eli Lilly's broader program for those with lower incomes), it's always worth checking the manufacturer's website or calling their patient services support center directly for the most up-to-date information on affordability solutions.

Pharmacy discount programs & coupons

Several third-party services offer discount cards or coupons that can help reduce the cash price of Mounjaro. Websites like GoodRx, SingleCare, and Optum Perks provide coupons that can lower the cost, sometimes by hundreds of dollars per fill. These coupons can often be used whether you have insurance (but are paying cash) or are uninsured. Be sure to compare prices at different local pharmacies, as prices can vary widely.

Ask your doctor about samples or alternatives

Your healthcare provider might have free samples available to help you start treatment or bridge a gap in coverage. Additionally, if Mounjaro's cost remains a barrier, your doctor can discuss other GLP-1 or GIP receptor agonist medications that might be more affordable or have different insurance coverage rules. This could include Ozempic or Wegovy, or, as mentioned, Zepbound if weight loss is the primary goal.

How to get the most value from Mounjaro, according to a dietitian

Even though the cost of Mounjaro is often not justified for obesity alone at current prices, it may be reasonable for select patients with type 2 diabetes and comorbid obesity, especially when paired with intensive lifestyle support.

Registered dietitians can help people maximize health outcomes through sustainable nutrition and behavior change, regardless of medication use. Here are some tips from Maria Kerialis, RD:

• Start with healthy habits: Mounjaro works best when combined with healthy eating and regular physical activity. These habits help improve blood sugar and weight, and they are key to keeping up the benefits if the medication is stopped.
• Follow the dosing plan: Mounjaro is injected once a week, starting at a low dose (2.5 mg) and increasing slowly to reduce side effects. The dose may be raised every 4 weeks, up to a maximum of 15 mg per week, depending on how well it works and how it is tolerated.
• Monitor for side effects: The most common side effects are stomach-related, like nausea or vomiting. These usually get better over time, especially if the dose is increased slowly. Drinking enough fluids can help prevent dehydration.
• Stay in touch with your healthcare team: Regular check-ins help track progress, adjust the dose, and watch for any problems.
• Plan for the future: Studies show that most people regain some weight after stopping medications like Mounjaro, but keeping up with healthy habits can help maintain some of the benefits. If long-term use is not possible, focus on building routines that support lasting health.
• Use the lowest effective dose: Some people do well on lower doses. Using the smallest dose that works for you can help reduce side effects and may lower costs.

Find a registered dietitian covered by insurance to help you get the most out of Mounjaro.

Making informed choices about Mounjaro

Understanding the cost of Mounjaro, exploring your insurance options, and knowing about available savings programs are vital steps in your health journey. While the list price can be intimidating, various avenues can help make this medication more accessible.

Always have open conversations with your healthcare provider about your treatment plan, potential costs, and any financial concerns you have. Together, you can explore the best strategies to manage your health effectively and affordably.

Frequently Asked Questions (FAQs)

How much does Mounjaro cost out of pocket?

Without insurance or any savings programs, the out-of-pocket cost for Mounjaro typically ranges from $1,000 to $1,200 for a one-month supply (four pens). This can sometimes be higher, depending on the pharmacy.

How much is Mounjaro with a savings card?

If you have commercial insurance and meet the eligibility criteria (including having a type 2 diabetes diagnosis), you could pay as little as $25 for a 1-month or 3-month supply using the Mounjaro Savings Card. This card has maximum savings limits per fill and annually.

Does insurance cover Mounjaro for weight loss?

Generally, no. Mounjaro is FDA-approved for type 2 diabetes, and most insurance plans will only cover it for this approved use. If you are seeking medication for weight loss, Zepbound (which contains the same active ingredient as Mounjaro) is FDA-approved for chronic weight management and may be covered by insurance for that purpose.

Is there a generic version of Mounjaro?

No, there is currently no FDA-approved generic version of Mounjaro (tirzepatide) available.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.