Vermont Medicaid

Does Vermont Medicaid cover Mounjaro?

Quick answer · Type 2 Diabetes

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

  • Medicaid: Covered (preferred drug). No additional clinical requirements listed.

Last verified June 4, 2026. Policy effective April 17, 2026. Source: Vermont-PDL-20260417.pdf. How we verify this data →

Check your card for your exact plan →

Mounjaro for Type 2 Diabetes

What Vermont Medicaid requires, by plan type. Open this indication on its own page →

Medicaid

Covered (preferred drug)

No additional clinical requirements are listed beyond the diagnosis.

Qualification pathways

You can qualify through any one of these.

Preferred GLP-1 for Type 2 Diabetes

All of:

  • Diagnosis of Type 2 Diabetes Mellitus

Documentation to bring

  • Documentation of Type 2 Diabetes Mellitus diagnosis

Quantity limits

  • all strengths — 12 pens/84 days (84-day)

Policy note: Mounjaro is listed as a preferred agent. Clinical criteria require a Type 2 Diabetes diagnosis. Treatment failure for GLP-1 products is defined as <1% reduction in HbA1c after 12 weeks at the maximally tolerated dose (applicable if used as a comparator for non-preferred step therapy). As a preferred agent, PA is required only after clinical criteria are met (T2DM diagnosis). No explicit step therapy through another GLP-1 is required for Mounjaro itself.

Policy effective April 17, 2026 · verified June 4, 2026 · source: Vermont-PDL-20260417.pdf

Why Mounjaro requests get denied by Vermont Medicaid

Based on what this policy asks for. Fix these before the first submission.

  1. Wrong brand for the diagnosis. Mounjaro and Zepbound are the same molecule with different approved uses; a request for Mounjaro under a diagnosis that matches Zepbound is routinely denied.

Frequently asked questions

Does Vermont Medicaid cover Mounjaro?
Vermont Medicaid covers Mounjaro for type 2 diabetes with prior authorization on Medicaid.
How current is this information?
This page reflects Vermont Medicaid's written policy as of April 17, 2026, last verified against the source document on June 4, 2026.

Other medications under Vermont Medicaid

Mounjaro coverage under other plans

All insurance plans · All medications

This page summarizes Vermont Medicaid's written prior-authorization policy. It is not a guarantee of coverage; plans vary by employer and benefit design. Verify with your plan before relying on it.