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Idaho Medicaid

Does Idaho Medicaid cover Mounjaro for Type 2 Diabetes?

Yes. Idaho Medicaid covers Mounjaro for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered with requirements. See the qualification pathways below.

Earliest policy review June 4, 2026. How we verify · Check your exact plan

Full requirements: Mounjaro for Type 2 Diabetes (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Non-preferred agent — T2DM diagnosis

All of:

  • ICD-10 diagnosis of type 2 diabetes mellitus in member's record or submitted with pharmacy claim

Documentation to bring

  • ICD-10 diagnosis code for type 2 diabetes mellitus in member's record or submitted with pharmacy claim

Policy note: Mounjaro (tirzepatide) is listed as a Non-Preferred Agent under the GLP-1 Receptor Agonists class. The document states criteria apply to preferred agents; the only criterion listed is an ICD-10 type 2 diabetes diagnosis. Non-preferred agents typically require PA on a Medicaid PDL; the document does not specify additional non-preferred criteria beyond the class-level T2DM diagnosis requirement. Rybelsus (semaglutide oral) is also listed as a Non-Preferred Agent and shares the same class criteria. Trulicity, Victoza, Bydureon BCISE, Byetta, and liraglutide also appear but are out of scope.

Policy effective January 1, 2026 · verified June 4, 2026 · source: Policy 396 · View policy document (PDF)

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Questions people ask
Does Idaho Medicaid cover Mounjaro?
Yes. Idaho Medicaid covers Mounjaro for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How current is this information?
The oldest review date among the policies on this page is June 4, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Idaho Medicaid: Ozempic

Mounjaro under other plans: Regence, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, Florida Medicaid

All insurance plans · All medications

Summary of Idaho Medicaid's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.