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Kaiser Permanente Northwest

Does Kaiser Permanente Northwest cover Mounjaro for Type 2 Diabetes?

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

Policy document

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

Earliest policy review June 5, 2026. How we verify · Check your exact plan

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

Applies to Employer plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Type 2 Diabetes Approval

All of:

  • Diagnosis of type 2 diabetes (ICD-10 Groups E08, E09, E13, or E11 except E11.A)
  • Diagnosis confirmed by medical records OR chart notes

Documentation to bring

  • Medical records or chart notes confirming type 2 diabetes diagnosis (ICD-10 Groups E08, E09, E13, or E11 except E11.A)

Approval and renewal

  • Initial approval: 12 months

Not covered when

  • ICD-10 code E11.A is explicitly excluded from qualifying T2DM diagnosis codes

Policy note: Approved for all strengths by GPID or GPI-14. ICD-10 code E11.A is explicitly excluded from the qualifying diagnosis codes despite being within the E11 group. Document does not address weight loss, CV risk reduction, or any other indication for Mounjaro.

Policy effective March 9, 2026 · verified June 5, 2026 · source: Mi All PA Guidelines Nw En · View policy document (PDF)

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Questions people ask
Does Kaiser Permanente Northwest cover Mounjaro?
Yes. Kaiser Permanente Northwest covers Mounjaro for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Mounjaro approval last with Kaiser Permanente Northwest?
Type 2 Diabetes — Applies to Employer plans. Initial approval: 12 months.
How current is this information?
The oldest review date among the policies on this page is June 5, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Kaiser Permanente Northwest: Ozempic, Wegovy, Zepbound

Mounjaro under other plans: Molina Healthcare, Oregon Medicaid, PacificSource Health, Premera, Regence, Washington Medicaid, Alabama Medicaid, Arkansas Medicaid

All insurance plans · All medications

Summary of Kaiser Permanente Northwest's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.