Does Georgia Medicaid cover Mounjaro?

Quick answer · Type 2 Diabetes

Georgia Medicaid covers Mounjaro for type 2 diabetes with prior authorization on Medicaid.

The card and program names below are mapped to Georgia Medicaid in our records. Coverage depends on the reason for treatment and the requirements in the policy.

Policy last verified June 4, 2026. Policy effective December 8, 2025. Source: download. How we verify this data.

Card and program names on file in Georgia

Select a name to read the Georgia Medicaid policy for Mounjaro. These are names we recognize, including older names and spelling variants; this is not a list of plans currently accepting members.

Don't see your card name? Check your card or call the pharmacy-benefit number on your card. If you also have Medicare, confirm which plan handles this prescription.

Mounjaro for Type 2 Diabetes

Medicaid

Covered with requirements

What you need to qualify

  • Age 18 and older
  • A1C of 7% or higher
  • Diagnosis documented with a code
  • Prior trial of 3 other GLP-1 medications (exenatide, Victoza, and Ozempic)
  • Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

T2DM on background antidiabetic therapy with prior GLP-1 failure

All of:

  • Age >= 18 years
  • Diagnosis of type 2 diabetes mellitus
  • HbA1c >= 7%
  • Currently on metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione therapy
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide, Victoza, AND Ozempic

Documentation to bring

  • Documentation of type 2 diabetes mellitus diagnosis
  • HbA1c lab result >= 7%
  • Documentation of current background antidiabetic therapy (metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione)
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to Victoza
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to Ozempic

Policy note: Mounjaro is listed as non-preferred under Miscellaneous Antidiabetic Agents. Requires step therapy through all three prior GLP-1 agents: exenatide, Victoza, AND Ozempic. Quantity level limits are referenced externally at the Georgia MMIS portal and not included in this document.

Policy effective December 8, 2025 · verified June 4, 2026 · source: download

Full Georgia Medicaid coverage page for Mounjaro

Other medications under Georgia Medicaid

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This page summarizes written Medicaid policies on file. It is not a guarantee of coverage or medical advice. Confirm your current benefits and prior-authorization requirements with your plan.