Does Anthem Blue Cross PPO cover Mounjaro?
Covered with prior authorization
Anthem Blue Cross PPO covers Mounjarowith prior authorization required.
This plan covers this medication, but requires prior authorization before it will pay.
Verbatim status from policy: Covered with PA
Last verified 2026-04-01.
Requirements
- Prior authorization
- Required
- Step therapy
- Not required
- Formulary tier
- Tier 3
Sources
- Anthem Blue Cross and Blue Shield Medicaid Ohio Medicaid Managed Care Provider Manual
Anthem Blue Cross and Blue Shield Medicaid (Ohio) · Effective 2025-10-01 · vOHBCBS-CD-PM-093342-25
- Medical Drug Clinical Criteria: Agents for Obesity; Wegovy (semaglutide) Clinical Criteria
Anthem / CarelonRx · Effective 2024-07-01 · vCC-0188; Pub-07-01-2024
- Imcivree (setmelanotide)
Anthem · Effective 2024-07-01 · vCC-0188
- Clinical Criteria: Agents for Obesity
Anthem / Elevance Health · Effective 2026-03-01 · vCC-0197; CC-0210
- Bariatric Surgery and Other Treatments for Clinically Severe Obesity
Anthem · Effective 2025-11-06 · vCG-SURG-83
What to do next
Your prescriber will need to submit a prior authorization request to your plan. Our guides walk through what they typically need to include.
Keep exploring
Other medications on this plan