Does TRICARE cover Zepbound, Wegovy, Ozempic or Mounjaro?

Coverage by TRICARE plan

TRICARE does not work like an employer plan. It sets one rule for each plan type. The split that matters is this: Prime and Select kept weight-loss coverage, and TRICARE For Life lost it.

TRICARE GLP-1 coverage by plan, checked Oct 18, 2026

Plan	Weight loss (Wegovy, Zepbound)	Type 2 diabetes (Ozempic, Mounjaro)	Source
TRICARE Prime and Select, including Prime Remote, Young Adult, US Family Health Plan, Reserve Select, Retired Reserve and CHCBP	Covered when medically necessary, with a network prescriber and prior authorization	Covered	[1] [2]
TRICARE For Life	Not covered since Aug 31, 2025	Covered	[1] [2] [9]
Direct care only (military hospital or clinic access only)	Not covered since Aug 31, 2025	Covered	[2]
Active duty service members	Request reviewed by Express Scripts first; reconsideration at a military treatment facility under military department weight policies	Covered	[5] [2]
Overseas Prime, Prime Remote Overseas, Select Overseas and others living abroad	Obesity qualifies as a primary condition, per a June 30, 2026 notice; 12-month approvals	Covered	[7]

Each drug on the TRICARE formulary

TRICARE status by drug and use

Drug	Formulary	Weight loss	Heart risk	Sleep apnea	Type 2 diabetes
Wegovy	Uniform Formulary, per the June 23, 2026 panel minutes [3]	Prime and Select with prior authorization [1] [5]	Not confirmed as a separate covered use; heart disease counts as a qualifying condition for the BMI 27 to 29 path [6]	Not an approved Wegovy use [17]	Not an approved Wegovy use [17]
Zepbound pens	Uniform Formulary, per the June 23, 2026 panel minutes; vials completely excluded [3]	Prime and Select with prior authorization [1] [5]	Not an approved Zepbound use [18]	Covered on the form: AHI 15+ and BMI 30+ [6]	Not an approved Zepbound use [18]
Ozempic	Recommended move from non-formulary to Uniform Formulary; effective date not confirmed [3]	Not an approved use [15]	Through diabetes coverage	Not an approved use [15]	Covered with prior authorization; the panel minutes say a metformin trial comes first [2] [3] [9]
Mounjaro	Recommended move from non-formulary to Uniform Formulary; effective date not confirmed [3]	Not an approved use [16]	Through diabetes coverage	Not an approved use [16]	Covered with prior authorization; the panel minutes say a metformin trial comes first [2] [3] [9]

Drug guides: Zepbound insurance, Wegovy insurance and Ozempic insurance.

The prior authorization: phentermine first

The Express Scripts prior authorization form for Wegovy and Zepbound pens covers only FDA-approved uses. Those are obesity, and moderate to severe sleep apnea in adults with obesity ^[5]. For adults it asks for:

• A BMI of 30 or more, or 27 to 29 with a listed weight-related condition, such as diabetes or impaired glucose tolerance ^[5]. A Sept 9, 2026 version posted by Martin's Point US Family Health Plan also lists established heart disease (prior heart attack, stroke or peripheral artery disease) as a qualifying condition ^[6].
• 6 months of behavior and diet changes ^[5].
• A prior 3-month trial of a generic oral weight-loss drug, such as phentermine, that did not produce 5% weight loss, unless the drug is contraindicated or caused an unexpected adverse reaction ^[5].
• For sleep apnea with Zepbound: an AHI of 15 or more and a BMI of 30 or more ^{[5] [6]}.

First approval lasts 12 months. To renew, adults need at least 5% weight loss, or better AHI scores for sleep apnea ^[5]. For ages 12 to 17, only Wegovy is covered, and the child needs a BMI at or above the 95th percentile ^[5]. The Express Scripts form we read is dated July 2, 2025 near its signature line. The Martin's Point version dated Sept 9, 2026 keeps the phentermine trial, the sleep apnea thresholds and 12-month approvals ^[6]. The June 2026 panel minutes list the phentermine step and yearly renewal among the prior authorization changes recommended in November 2025 ^[3].

What you pay in 2026

TRICARE 2026 pharmacy copays

Where you fill	Formulary brand (we apply this to Wegovy and Zepbound)	Non-formulary	Source
Retail network pharmacy, 30-day supply	$48 (up from $43)	$85	[4]
Home delivery, 90-day supply	$44	$85	[4]
Military pharmacy	$0	Not stated in our source	[4]
Active duty service members	$0	Not stated in our source	[4]

TRICARE For Life after Aug 31, 2025

On Aug 5, 2025, TRICARE announced new weight-loss drug controls that took effect Aug 31, 2025 ^[2]. They left out TRICARE For Life and direct-care-only beneficiaries and voided their existing prior authorizations ^[2]. MOAA's FAQ says those beneficiaries must pay 100% of the cost of weight-loss drugs from that date ^[9]. It lists Wegovy, Zepbound, Saxenda, Qsymia, phentermine and Contrave as affected. Ozempic, Mounjaro and Victoza keep coverage for type 2 diabetes ^[9].

A Defense Health Agency spokesperson told Military Times that TRICARE had been covering the drugs for people the federal statute does not make eligible: "This implementation corrects that unauthorized coverage." ^[8] MOAA says it found no statute that singles out TRICARE For Life beneficiaries for exclusion. It is pushing for updated federal rules ^[10].

Since July 1, 2026, the Medicare GLP-1 Bridge has covered Wegovy, Foundayo and the Zepbound KwikPen for weight management. The cost is $50 a month, through Dec 31, 2027 ^{[11] [12]}. It requires Part D coverage and a qualifying BMI ^[11]. So it helps a TRICARE For Life beneficiary only if they are also in a Part D plan. TRICARE's own page points Part D enrollees to the Bridge ^[1]. People with type 2 diabetes, moderate to severe sleep apnea or MASH cannot use the Bridge ^[11]. More: Medicare and GLP-1s.

Active duty and overseas rules

Active duty service members send weight-loss drug requests to Express Scripts for the first review. If it is denied, a military treatment facility reconsiders it under the service's weight policies ^[5]. Active duty members pay $0 copays ^[4].

On June 30, 2026, TRICARE said: "Obesity management now qualifies as a primary condition for GLP-1 medication coverage if you live overseas" ^[7]. This applies to Prime Overseas, Prime Remote Overseas, Select Overseas, Reserve Select, Retired Reserve and Young Adult beneficiaries living abroad ^[7]. You need an evaluation by a TRICARE network provider, a weight management plan, and care that follows local prescribing rules. Approvals last 12 months ^[7]. The notice names Wegovy, Saxenda, Victoza, Zepbound and Mounjaro as examples ^[7].

Changes since 2025

• Oct 1, 2026: TRICARE's weight-loss drug page last updated; it still limits coverage to Prime and Select ^[1].
• Aug 13, 2026: minutes of the June 23, 2026 panel posted: the panel concurred with November 2025 recommendations keeping Wegovy and Zepbound on the Uniform Formulary, Saxenda non-formulary, and moving Ozempic and Mounjaro to the Uniform Formulary ^[3].
• July 1, 2026: Medicare GLP-1 Bridge begins for Part D enrollees ^[11].
• June 30, 2026: TRICARE notice says obesity now qualifies as a primary condition for GLP-1 coverage overseas; no effective date stated ^[7].
• 2026 plan year: retail formulary brand copay rises to $48 from $43 ^[4].
• Nov 13, 2025: DHA previews 2026 pharmacy costs ^[4].
• Aug 31, 2025: TRICARE For Life and direct-care-only beneficiaries lose weight-loss drug coverage; their prior authorizations are voided ^[2].
• Aug 5, 2025: TRICARE announces the change ^[2].

How to check your TRICARE coverage

1. Confirm your plan: Prime, Select, TRICARE For Life, or direct care only. Only Prime and Select cover weight-loss drugs stateside ^[1].
2. Use a TRICARE network prescriber; TRICARE requires one for weight-loss drugs ^[1].
3. Ask your prescriber to document BMI, any weight-related condition, 6 months of diet and behavior changes, and the phentermine trial and its result ^[5].
4. Look up the drug and copay in the TRICARE Formulary Search on Express Scripts' TRICARE site, or call Express Scripts.
5. Active duty: expect the Express Scripts review first, then your military treatment facility if needed ^[5].

If TRICARE denies it

• Find the missing piece. Check the phentermine trial first, since the criteria require it ^{[3] [5]}. If phentermine is not safe for you, ask your prescriber to document the contraindication with the request; the form allows that ^[5].
• Appeal through Express Scripts using the denial letter's instructions and deadline.
• Self-pay, checked Oct 17, 2026: Wegovy pens $349 a month on NovoCare, $199 for each of a new self-pay patient's first two starting-dose fills through Dec 31, 2026, Wegovy HD $399, and the Wegovy pill $149 to $299 ^[13]. Zepbound on LillyDirect costs $299 to $449 per 28 days; the $449 price for 7.5 mg and up needs a refill within 45 days, or it rises to as much as $699 ^[14]. Manufacturer savings cards exclude government plans ^[13]. See Wegovy cost, Zepbound cost and the GLP-1 price tracker.
• On Medicare with Part D? Check the Bridge at $50 a month ^[11].

Civilian plans for comparison: UnitedHealthcare, Aetna, Cigna and Humana.

Compare TRICARE with other plans