This is a developing story. I'm still checking some costs, and I'll add updates here with dates.
I lost my job this month, and my health insurance goes with it on Nov. 1. The weekly pen I take for type 2 diabetes costs me $30 a month now. Without coverage, its list price is about $1,069. Keeping my old plan through COBRA would cost $1,065 a month. Is your medicine tied to your job too?
Where I am
I take Mounjaro, a once-a-week pen for type 2 diabetes. My doctor and I are still working out the right dose. With insurance, a month costs me $30. My coverage ends Nov. 1, 2026, along with my job.
What it costs without insurance
Eli Lilly, which makes Mounjaro, lists it at about $1,069 for a 28-day supply of four pens. See Lilly's pricing page. Lilly also sells Mounjaro directly to people paying cash. I'm confirming that price. Lilly's $25 savings card only works if you have commercial insurance.
My options, as I understand them
- Keep my plan through COBRA. Same coverage, for up to 18 months. Cost: $1,064.91 a month for medical, per my notice. I have 60 days to decide on COBRA. If I sign up and pay, coverage picks up from Nov. 1 with no gap. U.S. Department of Labor
- A marketplace plan. Losing job-based coverage opens a special enrollment window, usually 60 days. Cost: depends on income. HealthCare.gov
- AHCCCS, Arizona's Medicaid. Free or low-cost coverage if your income qualifies. Cost: income limits apply, and Lilly's savings card doesn't work with it. AHCCCS
- Pay out of pocket. Cost: the pen alone, with nothing else covered.
I'm leaning toward COBRA. It keeps the same plan, the same doctors and my $30 copay while I'm still finding the right dose. It's expensive, and I'm still checking whether AHCCCS would cover me for less.
What I'm checking next
AHCCCS: Health-e-Arizona Plus, healthearizonaplus.gov, 1-855-432-7587.
- Do I qualify, and does unemployment pay count as income?
- Is Mounjaro covered, and does it need prior approval?
- What would I pay each month?
- Can I keep my doctor?
Marketplace: HealthCare.gov, 1-800-318-2596. Same four questions.
What I got wrong
At first I mixed up Medicare and Medicaid. Medicare is mostly for people 65 and older. Medicaid, called AHCCCS here, is based on income. If you've mixed them up too, you're in good company.
You're not alone
Arizona's unemployment rate held at 4.9% in September 2026, compared with 4.2% nationally. Arizona Office of Economic Opportunity
What I'm doing first
Talking to my doctor before my coverage ends, so any pause is planned, not forced. If you take a medicine you shouldn't stop suddenly, start there too.
Has your coverage ended with a job? Tell me what you did, and how it turned out: ask@postmarq.org
Dave is the subject of this story. Research assisted by AI (Claude). Verified by Dave Contreras.