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Vermont Medicaid

Does Vermont Medicaid cover Mounjaro?

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

Policy document

  • Medicaid: Covered (preferred drug). 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 (preferred drug)

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 · View policy document (PDF)

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Questions people ask
Does Vermont Medicaid cover Mounjaro?
Yes. Vermont 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 Vermont Medicaid: Ozempic, Zepbound

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

All insurance plans · All medications

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