Does Humana cover Mounjaro?
From published formulary and policy documents for the plan type below. Not a decision for your member ID.
Sources last checked October 24, 2026
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Covered with restrictions. Mounjaro is on the 2026 Humana Premier PDP formulary at Tier 3. Humana requires pharmacies to enter a diagnosis code for a medically accepted indication when processing any GLP-1 claim, which in practice limits payment to type 2 diabetes (ICD-10 E08, E09, E11, E13).
Applies to: Medicare Part D (2026 Premier PDP, formulary ID 26402); type 2 diabetes indication
Source: Humana 2026 Commonly Prescribed Drug List, Premier PDP (Formulary ID 26402), 2026 plan year (Humana Ozempic page updated 2026-05-26)
Policy details
Sources last checked October 11, 2026
How to appeal
Humana Medicare Part D members, their appointed representative, or their prescriber can request a redetermination (appeal) after a denial. The request is due within 65 days of the date on the denial notice. Humana sends a written decision within 7 calendar days of receiving the request. Requests can be filed online, by mail or fax using the redetermination form, or by calling the Customer Care number on the member ID card. Expedited appeals have their own line, 800-867-6601.
Source: Humana: Medicare Part D coverage redetermination
What this means
The published policy describes how to request a redetermination after a denial.
This reflects the insurer's published formulary and policy for the plan type above. Your employer or plan may exclude weight-loss drugs or differ. Confirm with the number on your ID card.