Does TRICARE cover Zepbound?
Jump to section
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.
What TRICARE specifically requires
- Age 18 or older
- BMI of 30 or more, or 27 or more with diabetes, impaired glucose tolerance, dyslipidemia, hypertension or sleep apnea
- At least 6 months of behavior change and dietary restriction without reaching the desired weight loss
- A 3-month trial of a generic stimulant (phentermine, benzphetamine, diethylpropion or phendimetrazine) that did not produce 5% weight loss, unless contraindicated or not tolerated
- Approval: 12 months; renewal needs at least 5% loss from baseline after full dose titration
Sources: TRICARE Newsroom: coverage of weight loss medications (Aug 5, 2025); TRICARE prior authorization form: Wegovy, Zepbound (Express Scripts) (Form revised Aug 24, 2024); Defense Health Agency: 2026 TRICARE pharmacy costs (Nov 13, 2025)
About TRICARE coverage
- 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For Life and direct-care-only beneficiaries have no coverage for weight-loss drugs, and earlier approvals for them are no longer valid.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
Typical out-of-pocket
2026 TRICARE copays: $48 per 30-day supply of a brand-name formulary drug at a retail network pharmacy or $44 per 90-day supply by home delivery; non-formulary drugs cost $85 at either. Active duty service members pay $0. Actual copay depends on your specific plan's pharmacy benefit tier.
Where to get Zepbound
Telehealth services that handle Zepbound, useful while prior auth processes or as a cash-pay alternative. We may earn a commission. See disclosure.
Ro
from $149/mo- Best for insured patients
- Best for clinical oversight
Ro Body, branded GLP-1 weight care program
Hims
from $149/mo- Best for cash-pay
- Best for speed
Hims Weight Loss, branded GLP-1 on a monthly membership
TRICARE not the right plan?
Coverage varies between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 20 US insurers and programs, or run the insurance pre-check to estimate your specific plan's odds.
More TRICARE coverage
People also ask
Frequently asked
Does TRICARE cover Zepbound?+
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.
Does TRICARE require prior authorization for Zepbound?+
Yes. TRICARE requires prior authorization for Zepbound. Your prescriber submits the request with the documentation listed in the TRICARE criteria on this page.
What is the Zepbound copay with TRICARE?+
2026 TRICARE copays: $48 per 30-day supply of a brand-name formulary drug at a retail network pharmacy or $44 per 90-day supply by home delivery; non-formulary drugs cost $85 at either. Active duty service members pay $0. Actual copay depends on your specific plan tier and any pharmacy benefit manager carve-outs.