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Kaiser Permanente California

Kaiser Foundation Health Plan, Inc. (Northern and Southern California regions) · Drug benefit: Kaiser Permanente's own pharmacy (no outside PBM named for HMO plans) · 3 documents cited · Read September 2026

Both California HMO formularies list Wegovy on tier 2, and neither lists Zepbound, Foundayo or the Saxenda brand.

American GLP, Publisher · Who writes this site

Kaiser Permanente runs California as two regions, Northern and Southern, and publishes a commercial HMO formulary for each. Both were updated September 1, 2026, and on the drugs this site tracks they say the same thing.

Wegovy is on both lists, on tier 2, in every pen strength. Zepbound, Foundayo and the Saxenda brand aren't on either list. Each list does carry a generic liraglutide pen, and neither says whether that's for diabetes or weight.

The formulary isn't the whole answer. Both documents say they may vary by benefit plan and send you to your Evidence of Coverage to see which list applies and what you pay.

Is Wegovy covered on a Kaiser California HMO plan?

It's on the formulary, which means it's a drug Kaiser stocks and can cover. Whether your plan covers it for weight loss is a benefit question, and the formulary sends you to your Evidence of Coverage for that. Neither list prints a prior authorization code next to Wegovy; Kaiser's physicians prescribe under their own internal guidelines, which aren't published.

What if you want Zepbound or Foundayo?

Neither is on the Northern or Southern California HMO list, so it's a non-formulary request. Your Kaiser doctor would have to ask for it, and your plan has to cover weight-loss drugs at all. Ask Member Services which formulary your plan uses before you assume either answer.

Every claim above, with the document behind it

These are the policies we opened and the month we opened them. Each one carries its own policy number and effective date on its face, and those are printed here as the document shows them.

Northern California: "This prescription drug formulary is effective as of 09/01/2026. This formulary document may vary depending on your benefit plan. Refer to your Evidence of Coverage (EOC) to see which formulary applies to your benefit plan and the cost share that applies for each drug tier."

Kaiser Permanente, 2026 Northern California Commercial HMO Formulary, effective September 2026 · source

The Northern California list places each Wegovy pen on tier 2, among them "WEGOVY SOAJ 2.4 MG/0.75ML [semaglutide (weight management)]", with no prior authorization or quantity-limit code printed beside it.

Kaiser Permanente, 2026 Northern California Commercial HMO Formulary, effective September 2026 · source

Southern California carries the same Wegovy rows on tier 2, including "WEGOVY HD SOAJ 7.2 MG/0.75ML [semaglutide (weight management)]", under the same instruction: "Refer to your Evidence of Coverage (EOC) to see which formulary applies to your benefit plan and the cost share that applies for each drug tier."

Kaiser Permanente, 2026 Southern California Commercial HMO Formulary, effective September 2026 · source

We searched both HMO formularies for Zepbound, Foundayo, Saxenda, tirzepatide and orforglipron and found none of them; Wegovy appears in six strengths in each, and Ozempic is listed too. That's our reading of the two documents, not a statement Kaiser makes.

Kaiser Permanente, 2026 Southern California Commercial HMO Formulary · source

Self-funded EPO plans use a separate California list: it "does not provide information regarding specific coverage, including specific exclusions, copays, or coinsurances," and it lists "WEGOVY HD SUBCUTANEOUS SOLUTION AUTOINJECTOR 7.2 MG/0.75ML (semaglutide-weight management)".

Kaiser Permanente, 2026 California EPO / Deductible EPO Commercial (Self-Funded Plans) Formulary, effective September 2026 · source

What these documents cannot tell you

Everything above is what Kaiser Permanente California publishes. None of it establishes what your own plan does, and the gap between those two things is wider than a carrier policy makes it look.

  • These are the commercial HMO lists and the self-funded EPO list. Marketplace, Medi-Cal, Medicare, federal employee and PPO plans in California use other formularies.
  • A drug on the formulary isn't a promise your plan covers it for weight loss. Your Evidence of Coverage decides that.
  • Kaiser's internal prescribing guidelines for Wegovy in California aren't published, so we can't tell you the BMI or other tests your doctor will apply.
  • None of this is legal or medical advice. Your plan documents and your notice govern your case.

Where this comes from

  1. Kaiser Permanente, 2026 Northern California Commercial HMO Formulary, effective September 2026 — Open the document
  2. Kaiser Permanente, 2026 Southern California Commercial HMO Formulary, effective September 2026 — Open the document
  3. Kaiser Permanente, 2026 California EPO / Deductible EPO Commercial (Self-Funded Plans) Formulary, effective September 2026 — Open the document

Where to go next

American GLP is not a law firm, an insurer, a government office or a clinician, and nothing here is legal or medical advice. This page describes what Kaiser Permanente California publishes. It is not affiliated with Kaiser Foundation Health Plan, Inc. (Northern and Southern California regions), and your own plan documents and your own notice govern your case. Policies carry effective dates and change — read the sources before you act.