Last reviewed October 18, 2026
Wellcare is sending notices to members who take Mounjaro about a change to their 2027 drug coverage. Here is what the notice means in plain English and what you can do about it.
Will Wellcare still cover Mounjaro in 2027?
Yes. Mounjaro stays on Wellcare's drug list (the formulary) for 2027. What changes is the price group, or "tier," it sits in.
What exactly is changing?
On January 1, 2027, Mounjaro moves from Wellcare's Select Care Tier to the Injectable Tier. Each tier has its own cost, so what you pay at the pharmacy may change even though the drug is still covered.
Will I pay more?
Possibly. The Select Care Tier usually has a lower, fixed copay. On the Injectable Tier you may pay more per fill, and your cost may be a percentage of the drug's price (coinsurance) instead of a flat copay. Your exact cost depends on which Wellcare plan you have and whether you have met your deductible. Check your plan's 2027 Annual Notice of Change (ANOC) or Evidence of Coverage for the Injectable Tier cost.
Is there a limit to what I can pay?
Yes. In 2027, Medicare Part D caps your out-of-pocket spending on covered drugs at $2,400 for the year. Once you reach that amount, you pay $0 for covered drugs for the rest of 2027. The 2027 Part D deductible can be up to $700.
Do I need to do anything?
You do not have to. If you take no action, you stay on your Wellcare plan and the new tier applies on January 1, 2027. But this is a good year to compare plans. During Medicare Open Enrollment, October 15 through December 7, 2026, you can switch to a Part D or Medicare Advantage plan that covers Mounjaro at a lower cost. The new plan starts January 1, 2027.
How do I find out if another plan is cheaper?
Gather your full medication list (name, dose, and how often you take each one) and your preferred pharmacy. A licensed agent can compare every plan in your area for you at no cost. Call Independent Health Agents at 855-847-7020 (press 2 for Medicare) and we will run the numbers.
Comments
0 comments
Please sign in to leave a comment.