Vermont Medicaid coverage for Mounjaro (Type 2 Diabetes)

No additional clinical requirements are listed beyond the diagnosis.

Qualification pathways

You can qualify through any one of these.

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