According to joinfound.com, Mountjaro will be discontinuing the coupon after Dec. 31, 2023:
“If your insurance plan covers Mounjaro, your copay could be as little as $25 for up to 12 pens with the Mounjaro $25 coupon. The fine print: the Mounjaro $25 coupon program expires on December 31, 2023. Also, Eli Lilly may change the details and pricing for the Mounjaro $25 Savings Program at the company’s discretion.
“If your insurance doesn’t cover Mounjaro, the fine print says that you can get up to $575 off a one-month supply of the medication (consistent with a 28-day calendar month, so up to four pens). So, there’s a Mounjaro coupon you could qualify for even without insurance coverage. The Mounjaro coupon without insurance also expires on December 31, 2023.”
Previous Information
We have a huge number of inquiries about the recent changes to pharmacies’ acceptance of Mounjaro coupons and filling the prescription itself. Here is what we are telling everyone who contacts us:
As of 11/10/2022 the manufacturer of Mounjaro has changed their coupon guidelines.
Patients who received a coupon prior to this date should be okay to continue to use their existing coupon until 6-30-23 or 12 fills, whichever comes sooner. All Walgreens pharmacies require a diabetes diagnosis from a physician in order to process these prescriptions, even with the coupon.
Unfortunately, Mounjaro is only indicated at this time for type 2 diabetes. It is not indicated for prediabetes, insulin resistance, obesity, or metabolic syndrome. It is up to each pharmacy’s discretion to ask if this is being used for type 2 diabetes, and they can refuse to fill the prescription without a proper diagnosis code if they choose to. If you are using this medication and you are not diabetic, you will need to transfer your prescription to a different pharmacy. At this time, Walmart and CVS pharmacies appear to be filling the prescription without a diabetes diagnosis and accepting coupons dated prior to 11-10-22. We have found that different branches have different policies, though.
We are receiving an outpouring of patients requesting transfers to different pharmacies. In order to serve you more efficiently, we are asking that you, as the patient, transfer your own prescription to a pharmacy of your choice. To do that, you’ll need to contact possible pharmacies and specifically ask if you can transfer both your prescription AND your coupon. The list of local (OKC/Edmond area) pharmacies accepting referrals without a diagnosis code is changing rapidly, and we don’t have a list of which pharmacies to contact. When you find one that will accept the transfer, go ahead and call your current pharmacy back and make the switch. If clinic approval is needed, the pharmacy will automatically alert our providers – no call necessary.
If you would like to discuss different options other than Mounjaro, we do have some available. Please call to schedule an appointment if you’d like to discuss other medications. We are sorry for the inconvenience. If you have any further questions, please direct them to your patient advocate.
***We will update this post if and when more information becomes available.***
What is Mounjaro?
Mounjaro is a medication used to help with weight management, type 2 diabetes, and other ailments. It belongs to a class of drugs that are known for their ability to regulate blood sugar levels and potentially assist in weight loss. What’s unique about tirzepatide is its dual action – it works on both the GLP-1 receptor agonists and GIP receptors, which are involved in controlling blood sugar and appetite.
Clinical trials have shown promising results, especially for those with type 2 diabetes, indicating that tirzepatide might help in significant weight loss for individuals struggling with obesity. It’s administered through injections and is intended for people looking to manage their weight along with making healthy lifestyle changes, including diet and exercise.
However, it’s essential to discuss with your healthcare provider to understand if tirzepatide is suitable for you, considering your specific health needs and circumstances. It can also be quite expensive for some: more than $1,000 monthly in some cases. So check with your insurance plan to see if it covers Mounjaro.
Ways To Save on Mounjaro
Spending well over $10,000 a year on a much-needed prescription may be hard to swing for many patients who rely on Mounjaro. Here are a few things to consider if you’re looking to lighten the financial load.
Apply for a Mounjaro Savings Card Program
To apply for a Mounjaro Savings Card, you can typically visit the medication’s official website or contact the manufacturer directly. Often, these savings programs or cards are available online, where you can fill out a form with your personal information and prescription details.
Alternatively, you might find information about the discount card through your healthcare provider or pharmacist. The savings card can provide discounts or financial assistance to help reduce your out-of-pocket costs when purchasing Mounjaro if you meet the eligibility criteria.
Check Your Insurance
Depending on your health insurance plan, Mounjaro might be covered for treating Type 2 diabetes since it received FDA approval for that use. However, coverage for other uses, such as using Mounjaro for weight loss, may not be included in your plan. It’s essential to carefully review your insurance policy to determine if Mounjaro is covered so you have a clear understanding of what your insurance plan includes regarding Mounjaro and its approved uses.
Alternate Medications
If your insurance doesn’t cover Mounjaro, consider talking to your healthcare provider about alternative medications that your insurance does cover. This way, you can avoid having to pay the full cost yourself and still receive treatment for your condition. Exploring similar medications (Ozempic, Wegovy, etc.) that fit within your insurance plan can help manage your expenses while ensuring you get the necessary treatment.
Ask For an Exemption
Sometimes, your health insurance might not cover all the medications you need. If your plan doesn’t cover Mounjaro for your needs, you can ask them to make an exception. To do this, find out how your insurance handles requests for medications not on their list. Your doctor might need to write a letter explaining why Mounjaro is necessary for your condition.
Your insurance might also need you to fill out a form and give some documents to support your request. It’s a process to show why this medication is important for your health, even if it’s not usually covered. If denied, there may also be an appeals process you can follow to have them reconsider or if you feel they missed something important.
Buy More Up Front
At certain pharmacies, purchasing a 90-day supply of medication instead of a 30-day supply might come with special pricing or discounts. This could lead to lower copayments for you. However, before opting for a larger quantity, it’s important to ensure that your insurance covers this option.
Check if there are any specific rules regarding refills based on your location or the type of medication you’re prescribed. While getting more medication at once might save you money, it’s crucial to confirm that it aligns with your insurance coverage terms and conditions and doesn’t conflict with any prescription refill guidelines.
A New Use for Mounjaro: Zepbound
According to a PBS report from early November, the FDA has approved Mounjaro for weight loss under a new name: Zepbound. This may or may not change the way you can get this prescription or how pharmacies choose to accept insurance coverage or coupons.
The FDA greenlit the drug (made by Lilly) for individuals who are classified as obese, having a body mass index (BMI) of 30 or higher, or for those who are overweight with an associated health issue such as high blood pressure, high cholesterol, or diabetes. The FDA recommends combining the medication with a balanced diet and consistent exercise routine for optimal effectiveness.
In the United States, more than 100 million grown-ups and roughly 15 million kids are classified as obese. Two drugs, tirzepatide in Zepbound and Mounjaro, and semaglutide in Wegovy and Ozempic, work by acting like hormones that help control hunger and how full you feel after eating. They copy a hormone called GLP-1, which helps with appetite. Tirzepatide also focuses on another hormone called GIP, which is linked to insulin and blood sugar levels.