By MOAA Staff
TRICARE For Life (TFL) beneficiaries’ coverage for weight loss drugs will end Aug. 31 as part of new “regulatory controls,” according to an Aug. 5 TRICARE.mil article.
The change affects so-called “GLP-1” medications FDA-approved for weight loss, including brand names such as Wegovy and Zepbound. GLP-1 medications FDA-approved to treat Type 2 diabetes, such as Ozempic and Mounjaro, will remain covered for TFL and other TRICARE beneficiaries; that coverage requires prior authorization.
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 prior authorization criteria for weight loss drugs Wegovy and Zepbound using the TRICARE formulary search tool.
Share Your Story
MOAA’s advocacy relies on the testimony and experiences of service members and families impacted by changes to TRICARE policy. Will you, or someone you know, be affected by this change in TRICARE For Life coverage? Please share your story through Legislative Action Center at the link below.
TRICARE does not cover weight loss drugs for cosmetic reasons only – patients must have at least one weight-related comorbidity including hypertension, dyslipidemia, or metabolic dysfunction.
Actions to Consider
Patients affected by the change should receive a notice from TRICARE in the coming weeks, according to the article. Those who are unsure of their coverage eligibility should reach out to their provider to discuss options, which may include other treatment plans and/or lifestyle changes.
Beneficiaries also can contact Express Scripts with coverage questions.
Have More Questions About Your Health Care Benefit?
MOAA's TRICARE Guide answers some commonly asked questions.