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Mounjaro Part D coverage 2027

Mounjaro is a brand of tirzepatide. What agents check before quoting it: how many 2027 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.

Coverage at a glance

In 2027, 5,327 of 5,492 Medicare Part D and Medicare Advantage drug plans (97%) list Mounjaro on their formulary, across 271 of 286 formularies. The most common placement is tier 3 (4,887 plans, 91.7% of those covering it). 5,327 of the covering plans require prior authorization (100%), 0 step therapy and 5,326 a quantity limit.

What a 30-day fill costs

491 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $41, 93 of them $0; 4,836 charge coinsurance instead — median 20% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,400 in 2027, covered drugs cost $0 for the rest of the year.

What changed since 2026

2026: 5,343 of 5,496 plans covered it (97.2%); 2027: 5,327 of 5,492 (97%).

Of 4,367 plans offered in both years, 13 added it to the formulary and 18 dropped it.

Among plans covering it both years, 241 moved it to a higher tier and 95 to a lower one; 1 added prior authorization and 0 removed it.

Tier placement

TierPlans
Tier 1122
Tier 244
Tier 34,887
Tier 4268
Tier 51
Tier 65

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)322 of 32399.7%100%
Medicare Advantage with drugs (MA-PD)3,079 of 3,20096.2%100%
Special needs plans (SNP)1,926 of 1,96997.8%100%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana846 of 846Tier 3846
UnitedHealthcare830 of 830Tier 3830
Devoted Health728 of 728Tier 3728
Aetna Medicare631 of 631Tier 3631
Wellcare268 of 268Tier 4268
HealthSpring226 of 226Tier 3226
Kaiser Permanente0 of 112No tier listed0
SCAN Health Plan83 of 83Tier 383
Highmark Blue Cross Blue Shield or Highmark Blue Shield80 of 80Tier 380
Alignment Health Plan77 of 77Tier 377
Anthem Blue Cross and Blue Shield74 of 74Tier 374
Wellpoint63 of 63Tier 363
Priority Health Medicare40 of 40Tier 340
CarePlus Health Plans, Inc.37 of 37Tier 337
Zing Health36 of 36Tier 336
Capital Blue Cross35 of 35Tier 335
Prominence Health Plan29 of 29Tier 329
Medica27 of 27Tier 327
Anthem HealthKeepers26 of 26Tier 326
Blue Cross Blue Shield of Michigan26 of 26Tier 326

By state

StatePlans coveringShare
Alabama114 of 114100%
Alaska9 of 9100%
American Samoa1 of 1100%
Arizona147 of 147100%
Arkansas85 of 85100%
California344 of 39786.6%
Colorado95 of 10689.6%
Connecticut54 of 54100%
Delaware43 of 43100%
District of Columbia8 of 1266.7%
Florida527 of 54596.7%
Georgia141 of 14994.6%
Guam1 of 1100%
Hawaii44 of 5088%
Idaho45 of 45100%
Illinois132 of 132100%
Indiana138 of 138100%
Iowa63 of 6498.4%
Kansas84 of 84100%
Kentucky121 of 121100%
Louisiana125 of 125100%
Maine52 of 52100%
Maryland37 of 4975.5%
Massachusetts89 of 89100%
Michigan182 of 182100%
Minnesota58 of 6392.1%
Mississippi104 of 104100%
Missouri170 of 170100%
Montana26 of 2796.3%
Nebraska50 of 5198%
Nevada97 of 10097%
New Hampshire25 of 25100%
New Jersey72 of 7398.6%
New Mexico68 of 68100%
New York193 of 21589.8%
North Carolina176 of 176100%
North Dakota25 of 2696.2%
Northern Mariana Islands1 of 1100%
Ohio171 of 171100%
Oklahoma81 of 81100%
Oregon88 of 9295.7%
Pennsylvania323 of 323100%
Puerto Rico64 of 64100%
Rhode Island29 of 29100%
South Carolina89 of 89100%
South Dakota29 of 3096.7%
Tennessee156 of 156100%
Texas407 of 407100%
U.S. Virgin Islands1 of 1100%
Utah53 of 53100%
Vermont14 of 14100%
Virginia138 of 14495.8%
Washington98 of 11486%
West Virginia69 of 69100%
Wisconsin96 of 96100%
Wyoming12 of 1392.3%

Medicare usage

Medicare Part D paid for 6,093,349 30-day fills of Mounjaro in 2024 for about 894,243 enrollees, at an average total cost of $1,036.02 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Agent Tools

Price Mounjaro and the rest of a client's list on every plan in their county.

Estimate Mounjaro costs by plan

Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.

Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 10/08/2026). CMS formulary data.