Applies to Medicare Advantage plans.
Not coveredExclusion Criteria states: 'The member is using for weight loss.'
Policy note: Mounjaro is explicitly excluded when used for weight loss per the Exclusion Criteria of the MOUNJARO PA policy.
Policy effective July 1, 2026 · verified July 13, 2026 · source: 2026%20 Super%20 National%205%20 Mapd Prior%20 Authorizationpdf · View policy document (PDF)