Coverage at a glance
| Indication | Coverage |
|---|---|
| Type 2 diabetes | Covered with prior authorization |
Plan type: Commercial non-Medicare. Each indication below lists the BMI and clinical thresholds, the prior-authorization documentation, and the published policy it comes from.
Coverage by indication
What the prior authorization needs:
- Prior authorization required
- Covered for type 2 diabetes only, the FDA-approved indication; not covered for weight loss
- Quantity limits apply. The verified Michigan Medicaid list caps Mounjaro at 90 mL per fill, up to a 102-day supply
- Tier, step-therapy, and limit details vary by state and by Marketplace versus Medicaid plan
Source: Molina Healthcare of Michigan Preferred Drug List (Formulary), August 2026 to October 2026. formulary. Verified August 27, 2026. This row is marked lower confidence: the policy document was confirmed at its public URL but served as an unreadable file, so the policy number and framework were cross-checked against secondary sources.
What to do next
If you qualify under one of the covered indications above, prior authorization is the path. Match the documentation in the requirements list then have your prescriber submit it. Plans that approve reassess at renewal, so know your long-term maintenance dose before you start.
- Browse the prior-authorization letter library for a template that matches your plan and indication.
- Read the full coverage picture, denial reasons, and the four appeal pathways at GLP-1 insurance coverage.
- If the prior-authorization request is denied, the appeal letter library has templates by denial reason, covering peer-to-peer review, Level 1 and Level 2 internal appeal, and external review.
- If your plan does not cover the indication you need, compare cash prices in the cost guide or check whether a clinical trial near you fits. Neither one goes through your insurer. Clinical trials cost nothing and many pay you for your time. Some participants get a placebo, decided at random.
What it costs without insurance
The programs below bill you directly. Prices checked every Monday.
Frequently asked questions
Does Molina cover Mounjaro?
Molina covers Mounjaro for type 2 diabetes, the drug's FDA-approved use, but it requires prior authorization and applies quantity limits. Molina runs separate Marketplace and Medicaid formularies in each state, so the tier, any step-therapy rule, and the exact limits differ by plan and location. Mounjaro is not covered for weight loss. That indication belongs to Zepbound, which Molina lists in a separate anti-obesity section and restricts. Check the specific state plan's formulary before relying on coverage. This reflects the published policy verified August 2026.
What does Molina require to approve Mounjaro?
For type 2 diabetes: Prior authorization is required, with the documentation listed in the requirements above.
Coverage for other payers
See the full payer coverage index for every plan we have sourced.
How we built this page
Each page is built from a published payer policy document, government statute, or independent formulary analysis (KFF). Every indication row carries the source URL and the date we verified it. Where a payer's policy PDF was confirmed at its public URL but served as an unreadable binary, the policy number and coverage framework were cross-checked against secondary sources; those rows are marked lower confidence. Commercial coverage often depends on whether an employer elected the weight-management benefit. Those rows say varies by plan rather than a flat yes.
This is reference information, not medical or legal advice, and not a guarantee of coverage. GLP-1 coverage policies change often. Always confirm the current policy with your insurer using the number on your card before you rely on this page. If your experience differs from what is shown here, email hello@glpchart.com with the details and we will re-verify.
