Medicaid
Covered (preferred drug)What you need to qualify
- Diagnosis documented with a code
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