Policy note: Preferred GLP-1; approved for members with a diagnosis of type 2 diabetes. PA required (preferred products must meet eligibility criteria). Continuation allowed for members stable on Mounjaro 7.5/10/12.5/15 mg.
Policy effective March 1, 2023 · verified June 4, 2026 · source: 04-01-26%20PDL%20V1.pdf
Why Mounjaro requests get denied by Colorado Medicaid
Based on what this policy asks for. Fix these before the first submission.
Wrong brand for the diagnosis. Mounjaro and Zepbound are the same molecule with different approved uses; a request for Mounjaro under a diagnosis that matches Zepbound is routinely denied.
Diagnosis code missing or wrong on the request.
Frequently asked questions
Does Colorado Medicaid cover Mounjaro?
Colorado Medicaid covers Mounjaro for type 2 diabetes with prior authorization on Medicaid.
How current is this information?
This page reflects Colorado Medicaid's written policy as of March 1, 2023, last verified against the source document on June 4, 2026.
This page summarizes Colorado Medicaid's written prior-authorization policy. It is not a guarantee of coverage; plans vary by employer and benefit design. Verify with your plan before relying on it.