MOAA is urging the Defense Health Agency and lawmakers to halt plans that would end coverage of GLP-1 weight loss drugs for TRICARE For Life (TFL) beneficiaries in the coming days – plans which risk the progress made by patients taking these medications and cast doubt on the future of the TFL benefit.

TFL coverage of GLP-1 drugs that are approved by the Food and Drug Administration (FDA) to treat weight loss (Wegovy, Zepbound, Saxenda, Qsymia, Phentermine, or Contrave) is slated to end Aug. 31. Halting this policy change would provide time to assess the legislative and regulatory history governing TRICARE policy on weight loss medications and determine next steps to avert negative impacts to beneficiaries.

[TAKE ACTION: Halt Plans to End Weight-Loss Drug Coverage Under TRICARE For Life]

MOAA has collected considerable feedback from impacted patients, all of whom went through an extensive prior authorization and step therapy process to document comorbid conditions, lifestyle changes, and trials of alternative medications before meeting clinical criteria for approval. TRICARE does not cover these drugs for cosmetic purposes.  

These MOAA members attribute notable improvements to high blood pressure, sleep apnea, elevated A1C (a pre-diabetes indicator), and other medical conditions to their GLP-1 medications. They are worried progress will be reversed if they can no longer access such drugs. A physician from Walter Reed National Military Medical Center also reached out to MOAA with concerns about the new policy and its impact on Walter Reed’s military retiree patients.

[MEDIA COVERAGE: Military Times]

Members who are not directly impacted say the change represents a terrible precedent and could lead to further targeted cuts to TFL, the TRICARE benefit for Medicare-eligible military retirees. MOAA shares these concerns.

TRICARE Prime and TRICARE Select beneficiaries are not impacted by this change, but they are still subject to prior authorization for weight-loss drugs. You can find updated prior authorization criteria for GLP-1 weight loss medications using the TRICARE formulary search tool.

GLP-1 medications that are FDA-approved to treat Type 2 diabetes, such as Ozempic and Mounjaro, will remain covered for TFL and other TRICARE beneficiaries; that coverage also requires prior authorization.

[MOAA FAQ: TRICARE For Life and Weight-Loss Drugs]

Reliable health care coverage is essential to maintaining military readiness, supporting recruitment and retention, and honoring the nation's commitment to its armed forces. Please join us by contacting your elected officials to urge them to halt plans to end coverage of GLP-1 weight-loss medications for TFL beneficiaries.