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Kaiser Permanente Georgia

Kaiser Foundation Health Plan of Georgia · Drug benefit: Kaiser Permanente's own pharmacy (no outside PBM named) · 3 documents cited · Read September 2026

Its five-tier formulary puts Wegovy, Zepbound, Foundayo and Saxenda on the specialty tier, each needing prior authorization.

American GLP, Publisher · Who writes this site

Kaiser Permanente Georgia's five-tier formulary, current as of September 9, 2026, lists all four weight-loss drugs this site tracks: Wegovy, Zepbound, Foundayo and Saxenda.

All four sit on tier 5, the specialty tier, which is the highest cost share on the list. Each needs prior authorization, and Wegovy, Zepbound and Saxenda also carry a quantity limit.

Kaiser's criteria for those approvals aren't public: the Georgia criteria document is marked for internal Kaiser use only, so we don't quote it.

What will you pay?

Tier 5 is the specialty tier, so expect your plan's specialty cost share. The exact amount is in your Evidence of Coverage, and your doctor has to get the prior authorization before the pharmacy will fill it.

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.

"This document includes the Kaiser Permanente Georgia's 5 Tier Plan Benefit Formulary as of September 9, 2026."

Kaiser Permanente of Georgia, 2026 Five-Tier Formulary Benefit, effective September 2026 · source

Wegovy, Zepbound and Saxenda are listed on tier 5 with "PA, QL", and Foundayo on tier 5 with "PA". The key reads "Tier 4=Non-preferred Drugs, Tier 5=Specialty".

Kaiser Permanente of Georgia, 2026 Five-Tier Formulary Benefit, effective September 2026 · source

"Prior Authorization Medication (PA): For certain drugs, Kaiser Permanente requires review and authorization prior to dispensing. Your Provider must obtain this review and authorization."

Kaiser Permanente of Georgia, 2026 Five-Tier Formulary Benefit · source

"What you pay for covered drugs is determined by the outpatient prescription drug benefit outlined in your Evidence of Coverage."

Kaiser Permanente of Georgia, 2026 Five-Tier Formulary Benefit · source

Mid and large employer groups on the four-tier benefit see the same four drugs on their top tier, tier 4: Wegovy, Zepbound and Saxenda with "PA, QL" and Foundayo with PA. The document is Kaiser's "2026 Mid/Large Group 4 Tier Benefit" formulary, dated September 9, 2026.

Kaiser Permanente of Georgia, 2026 Mid/Large Group 4 Tier Benefit Formulary, effective September 2026 · source

The 2027 five-tier list keeps them there: it is the "5 Tier Plan Benefit Formulary as of January 1, 2027", with Wegovy, Zepbound and Saxenda on tier 5 with PA and QL, and Foundayo on tier 5 with PA.

Kaiser Permanente of Georgia, 2027 Five-Tier Formulary Benefit, effective January 2027 · source

What these documents cannot tell you

Everything above is what Kaiser Permanente Georgia 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.

  • This is the five-tier plan formulary. Georgia's four-tier, two-tier HMO, self-funded, state employee and federal employee plans use other lists.
  • The formulary doesn't say whether your plan excludes weight-loss drugs. Your Evidence of Coverage does.
  • Kaiser's Georgia approval criteria are marked internal, so we can't tell you what the prior authorization asks for.
  • None of this is legal or medical advice. Your plan documents and your notice govern your case.

Where this comes from

  1. Kaiser Permanente of Georgia, 2026 Five-Tier Formulary Benefit, effective September 2026 — Open the document
  2. Kaiser Permanente of Georgia, 2026 Mid/Large Group 4 Tier Benefit Formulary, effective September 2026 — Open the document
  3. Kaiser Permanente of Georgia, 2027 Five-Tier Formulary Benefit, effective January 2027 — 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 Georgia publishes. It is not affiliated with Kaiser Foundation Health Plan of Georgia, and your own plan documents and your own notice govern your case. Policies carry effective dates and change — read the sources before you act.