Lilly, the maker of Mounjaro, offers a savings card. For patients with a diagnosis of type 2 diabetes and commercial drug insurance but no coverage for Mounjaro the saving card will work. The Mounjaro discount program will last until 06/30/2023. You must have commercial drug insurance and not have coverage for Mounjaro to pay the $25 for a month supply of Mounjaro. The Mounjaro savings card is only for people with the FDA-approved indication of type 2 diabetes. Although Mounjaro works for weight loss in people who do not have diabetes, the savings card is only for people with a diagnosis of type 2 diabetes (as of October 1, 2022). Some pharmacists struggle with making the card work. Here are a few tips.
Where can one find the coupon if they don’t have it yet?
https://www.mounjaro.com/savings-resources
Who can use the coupon? Anyone with commercial insurance and a diagnosis of type 2 diabetes. People with Medicare or Medicaid cannot use this program under any circumstances.
How should the pharmacist handle this prescription?
Transmit claim online with RxBIN 018844. If a patient’s insurance has Mounjaro on formulary and it is covered, then pharmacy should submit the co-pay authorized by insurance as a secondary claim to Eversana using RxBIN 018844 and using the Coordination of Benefits field with Coverage Code type 08. The RxBin number is below but the Group Number and ID Number on the coupon. They will need to get those specific and unique numbers from the patient’s coupon. If a patient has insurance but Mounjaro is not on formulary or covered, they should continue to process the card along with patient insurance card using the Coordination of Benefits field with Coverage Code type 03. If the pharmacist is still having issues, they should call 1-855-282-4888.
Tirzepatide (Mounjaro) or any other weight loss medication is not a magic bullet but a tool to reduce appetite for long-term calorie reduction. Treating obesity can be complicated so it is best to work with a knowledgeable health care professional who is dedicated to working with you over the long run.
