Does TRICARE cover Wegovy or Zepbound in 2026?

TRICARE: "On Aug. 31, 2025, DHA began implementing revised prior authorization criteria for weight loss drugs. TRICARE no longer covers weight loss drugs for: TRICARE For Life beneficiaries; Beneficiaries who are only eligible for care at military hospitals and clinics; Beneficiaries with NATO status or Partnership for Peace Agreement." People in those groups "pay the full cost of the drug if you get the drug somewhere else, even if you had an approved prior authorization before Aug. 31." TRICARE still covers weight-loss drugs if "A TRICARE network provider prescribes them", they're medically necessary, and "You continue to meet prior authorization requirements", for the Prime and Select plans (including USFHP, Prime Remote, TRS, TRR and the TYA plans) and CHCBP.

TRICARE (Defense Health Agency), Weight loss products, effective August 2026 · source

TRICARE news, August 5, 2025: "These controls take effect Aug. 31, 2025. If you have TRICARE Prime or TRICARE Select, these medications are still covered in certain circumstances. Otherwise, if you have an approved prior authorization for weight loss drugs, it's no longer valid."

TRICARE Newsroom, effective August 2025 · source

Federal Register notice of October 28, 2025: "TRICARE is authorized to cover weight loss drugs for treating obesity, if obesity is the sole or major condition treated, only for TRICARE Prime and Select beneficiaries when such weight loss drugs are prescribed by a TRICARE network provider and are medically necessary and appropriate, and integrated into a comprehensive medical treatment plan."

Federal Register, Department of Defense notice 2025-19672, effective October 2025 · source

TRICARE's formulary search tool (dated 9/27/2026) lists the Wegovy 2.4 mg pen, the Zepbound 10 mg pen and Foundayo 9 mg for non-active-duty beneficiaries at $0.00 at a military pharmacy, $44.00 by home delivery and $48.00 at a retail network pharmacy (30-day supply), with $0.00 for active duty. Its coverage notes cap each at a 30-day supply at retail and up to a 60-day supply by home delivery or at a military pharmacy. Each carries the note "This medication is only covered for TRICARE Prime and TRICARE Select beneficiaries that have met the prior authorization criteria" and "Without this, you may pay full price for the medication."

Express Scripts for TRICARE, formulary search tool, effective September 2026 · source

Express Scripts' 2026 TRICARE copay notice: "Tier 2 Brand-Name Formulary drugs will increase from $38 to $44" at home delivery and "from $43 to $48" at retail network pharmacies.

Express Scripts (TRICARE pharmacy), 2026 copayment changes · source

TRICARE's Wegovy FAQ, under its list of groups TRICARE does not cover for weight-loss drugs, says: "You will pay 100% of the cost for your weight loss drugs even if you have an approved prior authorization."

TRICARE, FAQ: Wegovy and weight loss drugs, effective August 2026 · source

TRICARE overseas Q&A, June 30, 2026: to qualify you must "Have a diagnosis of obesity; Meet age and Body Mass Index criteria; Have an evaluation by a TRICARE network provider; Take part in a weight management plan", and "your prior authorization will be valid for 12 months" before you must requalify.

TRICARE Newsroom, effective June 2026 · source

TRICARE: "TRICARE still covers certain drugs (such as Ozempic, Mounjaro, Trulicity, and Victoza) for all patients to treat diabetes when medically necessary. You must meet prior authorization requirements. Copayments and cost-shares for these drugs haven't changed."

TRICARE (Defense Health Agency), Weight loss products, effective August 2026 · source

TRICARE on Medicare: "Some Medicare Part D plans may cover drugs that TFL doesn't cover… Beginning July 1, 2026, Medicare Part D covers certain weight loss drugs under the Medicare GLP-1 Bridge Program." It adds that "TRICARE is creditable prescription drug coverage" and "TRICARE will pay second after Medicare."

TRICARE, Pharmacy: Medicare-eligible beneficiaries, effective July 2026 · source

TRICARE pharmacy appeals: you may appeal a denied "Pre-authorization". The appeal must "Be in writing and signed; State specifically why you disagree; Include a copy of the claim decision; Be postmarked or received by Express Scripts within a deadline of 90 calendar days from the date of the decision to appeal." The address is Express Scripts, Inc., P.O. Box 60903, Phoenix, AZ 85082-0903.

TRICARE, Pharmacy appeals, effective May 2025 · source

Lilly's Zepbound savings card terms require that "You are not enrolled in any state, federal, or government funded healthcare program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medicare Advantage, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any state prescription drug assistance program." You must also be "a resident of the United States or Puerto Rico" and "18 years of age or older."

Eli Lilly and Company, Zepbound Savings Card terms and conditions, effective August 2026 · source

The separate self-pay KwikPen card "is for self‑paying (cash) patients only": you agree that you "will not seek or accept reimbursement… from any third‑party payer, including private insurance or state or federal healthcare programs, nor apply those costs toward any deductible or true out‑of‑pocket requirements." Its eligibility list is residency in the United States or Puerto Rico and age 18 or older, with the same $299, $399 and $449 prices and "a maximum of up to 11 prescription fills per calendar year." On Lilly's savings page this option appears under the Medicare, "Government (other)" and "No insurance" choices.

Eli Lilly and Company, Zepbound self-pay KwikPen terms and conditions, effective August 2026 · source · savings page

CMS: "an eligible GLP-1 drug is any of the following products when used to reduce excess body weight and maintain weight reduction: Foundayo®, Wegovy® (injection and tablets), and Zepbound® (KwikPen®)." The page notes: "This was updated on April 6, 2026, to include Foundayo® following FDA approval."

Centers for Medicare & Medicaid Services, Medicare GLP-1 Bridge: information for Part D plans, effective August 2026 · source

CMS: the Bridge gives access "between July 1, 2026, and December 31, 2027." "Eligible beneficiaries will have a $50 copay … the Part D deductible will not apply, no part of the $50 copay counts towards the beneficiary's TrOOP costs, and there is no low-income subsidy (LIS) provided for LIS beneficiaries."

Centers for Medicare & Medicaid Services, Medicare GLP-1 Bridge, effective July 2026 · source

VA: "CHAMPVA doesn't cover prescription GLP-1 medications for weight loss." It covers Zepbound for moderate to severe obstructive sleep apnea, and Wegovy for MASH or to prevent major cardiovascular events after prior events.

US Department of Veterans Affairs, Meds by Mail for CHAMPVA, effective August 2026 · source