How Much Does Mounjaro Cost (With and Without Insurance)

What is Mounjaro?

Mounjaro (tirzepatide) is a prescription medication approved by The Food and Drug Administration (FDA) primarily used to treat type 2 diabetes. It is a GLP-1 receptor agonist and GIP receptor agonist, meaning it works by stimulating the body’s natural insulin production while also helping regulate blood sugar levels. This dual action makes Mounjaro highly effective in controlling blood glucose, especially in patients who struggle to achieve target levels with other medications.

In addition to its role in diabetes management, Mounjaro has also gained attention for its weight loss benefits. Many patients taking Mounjaro have experienced significant weight loss, which has led to its off-label use as an obesity management tool. However, the high cost of Mounjaro can be a significant barrier, making alternatives like LookMeds' compounded semaglutide a more accessible option for many patients.

The High Cost of Mounjaro Without Insurance

If you're paying for Mounjaro out-of-pocket, you're likely in for a financial shock. On average, Mounjaro's list price, according to its manufacturer, Eli Lilly, is about $1,069.08 per fill. Four pre-filled pens are included in each fill, which is roughly a one-month's supply of Mounjaro. 

Depending on the pharmacy, the typical retail price per fill without health insurance might range from $1,000 to $1,200 or more. Several factors can influence the price of Mounjaro, such as:

• Your Location: The cost of prescription medications can vary depending on your city or region. In some areas, medication prices tend to be higher compared to other areas.

• Pharmacy: Prices for Mounjaro can vary between pharmacies; it’s a good idea to check with different pharmacies in your area to compare prices and choose the most affordable option.

• Reason for Prescription: If you are prescribed Mounjaro for type 2 diabetes, your insurance may cover part of the cost. However, if it’s prescribed for weight loss, which is considered off-label use, you might have to pay out-of-pocket. You can also ask your healthcare provider about other alternatives, such as Zepbound, which may be covered by your insurance.

• Prescription Discounts: You can also look into using prescription discount programs or pharmacy coupons, which may help reduce the cost of Mounjaro.

Why Is Mounjaro So Expensive?

Several factors contribute to the high cost of Mounjaro:

1. New Drug Status: Mounjaro was only recently approved by the FDA for treating type 2 diabetes, meaning it is still under patent protection. This allows the manufacturer to set high prices as there are no generic versions available yet.
   
2. Advanced Mechanism of Action: Mounjaro’s dual receptor action is unique and more complex than many older diabetes medications, contributing to its higher price.
   
3. Demand for Weight Loss: Because Mounjaro is also being used for weight loss, there is a growing demand for the medication, especially from patients looking to achieve significant weight reduction. This has driven up the cost even further in some areas.

The Cost of Mounjaro With Insurance

If you have health insurance, the cost of Mounjaro can vary significantly depending on your plan’s coverage and whether the medication is prescribed for Type 2 diabetes or off-label use like weight loss. However, there are several ways to lower the cost, even with insurance, including utilizing Mounjaro savings cards.

Factors Affecting Mounjaro's Cost with Insurance:

• Copay or Coinsurance: Most insurance plans require you to pay a portion of the cost through a copay or coinsurance. This can range from $25 to $100 per month, depending on your plan's formulary.
  
  
• Prior Authorization: Some insurance companies require prior authorization before covering Mounjaro. This process ensures the medication is medically necessary for treating type 2 diabetes or other conditions. Once approved, you could save significantly on the monthly cost.
  
  
• Deductible: If you have a high-deductible plan, you may need to cover the full price of Mounjaro until you meet your deductible. After the deductible is reached, your insurance provider may help cover the cost, reducing your out-of-pocket expenses.
  
  
• Plan Type: The type of insurance plan you have, such as an HMO, PPO, or high-deductible health plan (HDHP), impacts how much you’ll pay for Mounjaro. PPO and HMO plans may offer more immediate savings, while HDHPs may require more upfront costs until the deductible is met.
  
  
• Off-Label Use: If you’re prescribed Mounjaro off-label for weight loss, your insurance might not cover it. In this case, you'll be responsible for the full cost unless your healthcare provider successfully appeals for coverage as a medical necessity.

How to Get Mounjaro for Cheaper Prices

There are various ways you may be able to get Mounjaro at a discounted price.

With Insurance

If you have insurance, there are several ways to reduce the cost of Mounjaro. Many insurance plans, especially for patients with Type 2 diabetes, may cover part of the cost, but other methods exist to lower your expenses even further.

1. Mounjaro Savings Cards

For patients who have insurance but still face high copayments or coinsurance, Mounjaro savings cards can provide significant financial relief. These savings cards, often offered by the drug manufacturer, can reduce the monthly cost to as low as $25 to $100 per month for patients who meet their eligibility requirements.

2. Prior Authorization

In some cases, your healthcare professional may need to provide additional information to your insurance company to prove medical necessity. If approved, this can significantly lower your out-of-pocket cost. This process is especially common when medications are prescribed off-label, such as with these weight loss drugs.

Without Insurance

For those without insurance or Mounjaro coupons, paying for Mounjaro entirely out-of-pocket can be burdensome. However, there are several ways to reduce the financial impact:

1. Prescription Assistance Programs:

Some organizations and manufacturers, like SingleCare, offer prescription assistance programs for patients who meet certain income requirements. These programs can provide free or discounted medications to those in need.

2. Pharmacy Coupons and Discounts:

Many pharmacies offer discount cards or coupons that can significantly reduce the cost of medications. Although these discounts vary, they can sometimes lower the price of Mounjaro by up to 80%. Be sure to ask your pharmacy about available savings programs.

3. Consider Alternative Medications:

If Mounjaro is unaffordable, speak with your doctor about alternative medications that may provide similar benefits at a lower cost. Options like Zepbound, which contain the same active ingredient, can offer significant savings.

4. LookMeds Compounded Tirzepatide:

For those without insurance, LookMeds offers an affordable alternative with their compounded tirzepatide, at just $349/month for tablets and $449/month for injections, with a $100 discount off the first month. This option provides a much more budget-friendly solution without sacrificing quality or effectiveness.

Medicare or Medicaid

If you’re enrolled in Medicare or Medicaid, your coverage for Mounjaro will depend on your specific plan and whether you’re prescribed it for type 2 diabetes or off-label use (weight loss).

Medicare:

Medicare Part D typically covers prescription drugs, including Mounjaro prescription, if it’s prescribed for Type 2 diabetes. However, you’ll likely have to meet certain requirements, such as prior authorization or being enrolled in a specific tier of the plan. While Medicare may cover a portion of the cost, you will likely still have copayments, which can range from $25 to $100 or more, depending on your plan.

Medicaid:

Medicaid coverage for Mounjaro varies by state. Some state Medicaid programs may cover Mounjaro for type 2 diabetes, but off-label use (such as for weight loss) is typically not covered. Check with your local Medicaid office to find out what’s available in your state and whether you qualify for additional assistance.

How to Maximize Savings with Medicare or Medicaid:

• Consult Your Plan: Speak with a Medicare or Medicaid representative to understand your coverage and copayment responsibilities.
  
• Appeal for Coverage: If Mounjaro isn’t covered for weight loss, you can file an appeal with your plan, citing medical necessity.
  
• Seek Out Coupons and Savings: Even with Medicare or Medicaid, coupons and savings programs can further reduce out-of-pocket costs for Mounjaro.

Why Choose LookMeds Over Mounjaro?

While Mounjaro is a highly effective medication, its cost can be an obstacle for many people, especially those without insurance. Fortunately, LookMeds offers a more affordable option with their compounded tirzepatide products, which are significantly cheaper than brand-name drugs and equally as effective.

LookMeds' TirzepatidePricing:

• Tablets: $349/month
  
• Injections: $449/month

This pricing makes LookMeds a great option for those seeking the benefits of tirzepatide at a significantly reduced cost compared to brand-name Mounjaro. Whether you have insurance or not, LookMeds provides a solution that fits into more budgets, allowing patients to get the care they need without breaking the bank.

What Makes LookMeds Special?

When it comes to health and chronic weight management, choosing the right provider is crucial. LookMeds sets itself apart by offering:

• Affordable Pricing: LookMeds’ tirzepatide is priced lower than brand-name medications, making it accessible to a wider range of patients.
  
• High-Quality Compounds: LookMeds ensures their tirzepatide products are made with the highest standards, ensuring safety and effectiveness.
  
• Convenient Monthly Plans: LookMeds offers straightforward, predictable monthly pricing that helps you manage your medication costs more easily.

Comparing Costs: Mounjaro vs. LookMeds Compounded Tirzepatide

• Mounjaro (Without Insurance) costs up to $1,200 per month.
• Mounjaro (With Insurance) may have a co-pay of $25 to $100 per month.
• LookMeds compounded Mounjaro tablets are $349 per month.
• LookMeds compounded Mounjaro injections are $449 per month.

The Bottom Line

Considering the high cost of this beneficial treatment for Type 2 diabetes and weight loss, it can be difficult to navigate Mounjaro's cost. It's important to know your options, whether paying out-of-pocket or through insurance.

However, you’re not limited to name-brand products. LookMeds provides a useful and cheaper alternative with its tirzepatide products, which offer the same advantages at much lower costs ($349/month for tablets and $449/month for injections) and often offer discounts and special offers to further your savings.

By choosing LookMeds, you can access high-quality compounded tirzepatide that fits your budget while maintaining effective diabetes management and weight loss support. Don’t let the high costs of medications hold you back.

‍Get started with LookMeds today and take control of your health without breaking the bank.