Does TRICARE cover GLP-1 medications?
military
TRICARE provides health coverage to US military service members, retirees, and their families.
What TRICARE specifically requires
- Since August 31, 2025, TRICARE For Life and direct-care-only beneficiaries have no coverage for weight-loss drugs, and earlier approvals for them are no longer valid. TRICARE Newsroom: coverage of weight loss medications, Aug 5, 2025
- Weight-loss drug coverage applies to TRICARE Prime, TRICARE Select, TRICARE Young Adult, TRICARE Reserve Select, TRICARE Retired Reserve and the Continued Health Care Benefit Program, with a prescription from a network provider. TRICARE Newsroom: coverage of weight loss medications, Aug 5, 2025
- The Wegovy and Zepbound prior authorization form requires a 3-month trial of a generic stimulant such as phentermine that did not produce 5% weight loss, unless it is contraindicated or not tolerated. TRICARE prior authorization form: Wegovy, Zepbound (Express Scripts), Form revised Aug 24, 2024
- Approvals last 12 months. Renewal requires at least 5% loss from baseline after full dose titration (4% for Wegovy in ages 12 to 17). TRICARE prior authorization form: Wegovy, Zepbound (Express Scripts), Form revised Aug 24, 2024
- 2026 copays: $48 per 30-day supply of a brand-name formulary drug at a retail network pharmacy, $44 per 90-day supply by home delivery; active duty service members pay $0. Defense Health Agency: 2026 TRICARE pharmacy costs, Nov 13, 2025
TRICARE coverage by drug
- Covered (prior auth required)Wegovysemaglutide
TRICARE Prime and Select, plus Young Adult, Reserve Select, Retired Reserve and CHCBP, cover Wegovy for weight loss with prior authorization and a prescription from a network provider. TRICARE For Life and direct-care-only beneficiaries lost weight-loss drug coverage on August 31, 2025.
- Covered (prior auth required)Zepboundtirzepatide
TRICARE covers Zepbound for weight loss on Prime, Select and the premium-based plans under the same prior authorization form as Wegovy, but only for adults: the form does not approve Zepbound under age 18. TRICARE For Life and direct-care-only beneficiaries have had no weight-loss drug coverage since August 31, 2025.
- Covered (prior auth required)Ozempicsemaglutide
TRICARE covers Ozempic for type 2 diabetes for all beneficiaries, including TRICARE For Life, with prior authorization. A medical necessity form is also required for the formulary copayment and for coverage at a military pharmacy. The Wegovy/Zepbound form does not approve those drugs for diabetes.
- Covered (prior auth required)Mounjarotirzepatide
TRICARE covers Mounjaro for type 2 diabetes for all beneficiaries with prior authorization, plus a medical necessity form for the formulary copayment and for coverage at a military pharmacy.
- Covered (prior auth required)Saxendaliraglutide
TRICARE lists Saxenda among covered weight-loss medications for Prime, Select and the premium-based plans, with prior authorization and a network prescriber. TRICARE For Life and direct-care-only beneficiaries are excluded since August 31, 2025.
- CoveredZoloftsertraline
Generic sertraline is on military and VA formularies. Check the formulary for your copay.
- CoveredLexaproescitalopram
Generic escitalopram is on military and VA formularies. Check the formulary for your copay.
- Limited coverageViagrasildenafil
TRICARE covers PDE5 inhibitors such as sildenafil only when erectile dysfunction has a physical (organic) cause, not a psychological one, subject to limits set by the DoD Pharmacy and Therapeutics Committee. Check the TRICARE Formulary Search for the current quantity limit.
- Limited coverageCialistadalafil
TRICARE covers tadalafil for erectile dysfunction only when the cause is physical (organic), subject to limits set by the DoD Pharmacy and Therapeutics Committee. Check the TRICARE Formulary Search for the current quantity limit.
- Limited coveragePropeciafinasteride
Finasteride 5 mg for BPH is commonly on formulary; the 1 mg dose for hair loss is often excluded. Check the formulary.
Reminder: coverage varies by plan
TRICARE offers many plan designs. The same medication can be covered under one TRICARE plan and excluded from another. Always confirm with your specific plan's formulary or call the number on your insurance card before assuming coverage.
Frequently asked
Does TRICARE cover GLP-1 medications for weight loss?+
TRICARE covers weight-loss drugs such as Wegovy, Zepbound and Saxenda only for TRICARE Prime, TRICARE Select and the premium-based plans, with prior authorization through Express Scripts. Since August 31, 2025, TRICARE For Life and direct-care-only beneficiaries have no coverage for weight-loss drugs. GLP-1s for type 2 diabetes remain covered with prior authorization. GLP-1 coverage at TRICARE varies plan by plan. For Wegovy and Zepbound (weight-loss indications), expect prior authorization at minimum, with formal documentation of BMI and previous lifestyle interventions. For Ozempic and Mounjaro (type 2 diabetes), coverage is generally easier when prescribed for diabetes.
Does TRICARE require a prior authorization for Wegovy or Zepbound?+
Yes, prior authorization (PA) is the norm for weight-loss GLP-1s across TRICARE plans. A PA typically requires documented BMI ≥30 (or ≥27 with a comorbidity), prior attempts at structured weight loss, and sometimes step-therapy through cheaper alternatives. Your prescriber's office files the PA.
How do I check if my specific TRICARE plan covers a drug?+
Three steps: (1) Log into your TRICARE member portal and search the drug formulary by name. (2) Call the member services number on your insurance card. (3) Ask your prescriber to submit a benefits inquiry. Plan designs differ widely within TRICARE — what's covered for one member may not be covered for another.
What if TRICARE denies my GLP-1 prior authorization?+
Three options: (1) Appeal — most plans grant an appeal that adds physician peer-to-peer review; your prescriber can request this. (2) Switch indication if clinically appropriate (e.g., if you have prediabetes and BMI ≥30, your physician may have different coverage paths). (3) Use manufacturer direct-pay (NovoCare, LillyDirect) which doesn't depend on insurance approval. Federal program coverage policies follow CMS rules and have less plan-by-plan variability — appeals are still available.
Are compounded GLP-1s covered by TRICARE?+
Generally no. Most insurance plans, including TRICARE, do not cover compounded semaglutide or tirzepatide regardless of pharmacy. As of 2026, the FDA is winding down large-scale compounding, so coverage questions are increasingly moot — most patients are transitioning to branded GLP-1s or manufacturer direct-pay programs.