TRICARE, FEHB and PSHB: Who Covers Wegovy and Zepbound in 2026

TRICARE covers Wegovy, Zepbound and Saxenda for weight management only for people enrolled in Prime or Select, or in the premium plans that follow their rules, and only with prior authorization.^[1] TRICARE For Life does not cover them at all, because federal law does not allow it.^[3] Federal employees and retirees in FEHB or PSHB plans are in a different position: OPM obliges every carrier to put a weight-loss GLP-1 on its formulary, though each plan sets its own prior-authorization rules and tier.^[7] In every case the plan’s own documents decide what you pay.

Which TRICARE plans cover weight-loss drugs

TRICARE’s pharmacy FAQ, last updated August 6, 2026, names the plans that can cover Wegovy, Saxenda and Zepbound for weight management:^[1]

The covered-services page, updated October 1, 2026, gives the same split and adds the overseas versions of Prime and Select.^[2] Express Scripts, which runs the TRICARE pharmacy benefit, lists Contrave, Qsymia and phentermine alongside Wegovy and Zepbound as covered weight-loss drugs for Prime and Select members with an approved prior authorization.^[4] TRICARE’s FAQ asks for a prescription from a network provider; Express Scripts says a TRICARE-authorized provider, including one at a military hospital or clinic, and a TRICARE network pharmacy.^[1][4]

What TRICARE members pay

Here TRICARE’s own pages do not agree. The FAQ contains this sentence, set directly beneath its list of excluded groups: “You will pay 100% of the cost for your weight loss drugs even if you have an approved prior authorization.”^[1] Read in place, it may refer only to the excluded groups above it, but the page does not say so. The covered-services page says instead that “your costs depend on who you are, the drug category, and where you fill your prescription.”^[2] Neither page prints a copay for Wegovy or Zepbound.

The formulary committee’s record points toward ordinary cost-sharing for covered members: its November 2025 review kept Wegovy and Zepbound on the uniform formulary, the tier with the lower copays, and moved Saxenda to non-formulary.^[5] Before you fill a prescription, look the drug up in the TRICARE Formulary Search Tool or ask Express Scripts what your plan charges for it. If the answer is the full price, the cash routes are in our guide to paying for a GLP-1 without coverage. Manufacturer copay cards will not help: Lilly’s Zepbound savings card excludes government beneficiaries and names TRICARE among them.^[12]

TRICARE’s prior authorization, and the changes coming

TRICARE requires prior authorization for every weight-loss GLP-1, and the form for your drug is on the Formulary Search Tool.^[1] In November 2025, the Defense Health Agency’s pharmacy committee recommended tightening those criteria, and its beneficiary advisory panel concurred on June 23, 2026.^[5] The changes, as the record describes them:

• Phentermine first. A trial of generic phentermine, or one of the older generic phentermine derivatives, before Wegovy, Zepbound or Saxenda.^[5]
• Diabetes products for people with diabetes. Patients with diabetes would try one of the diabetes GLP-1s, which share active ingredients with the weight-loss brands.^[5]
• Annual renewal, and the existing requirement for lifestyle changes kept.^[5]
• A stricter reading of uncontrolled hypertension: blood pressure above the individual goal on two or more blood pressure drugs.^[5]

The record says the new criteria take effect the first Wednesday 60 days after the minutes are signed, and the signing date was not published.^[5] The record describes the updated criteria as applying to new users, so ask Express Scripts which version applies to a renewal. If a request is denied, the steps are in GLP-1 prior authorization and appeals.

One product is ruled out entirely. The committee kept Zepbound vials in “complete exclusion status” because Lilly sells them only for self-pay.^[5] How the vial works and what it costs on its own is covered in Zepbound vials and syringes.

TRICARE For Life and the Medicare Bridge

TRICARE For Life sits on top of Medicare, and a different law governs it. TRICARE’s explanation is blunt. The statute behind TFL gives it no authority to pay for a drug whose main purpose is weight loss, at any age, and that stays true when the patient has other medical conditions as well.^[3] That is why TFL does not follow Medicare’s exceptions for sleep apnea or heart disease. Coverage for TFL members ended on August 31, 2025.^[3]

The route that opened since then runs through Medicare, not TRICARE. TRICARE’s FAQ notes that since July 1, 2026, Medicare Part D covers certain weight-loss drugs under the Medicare GLP-1 Bridge.^[1] The Bridge covers Foundayo, Wegovy and the Zepbound KwikPen for a $50 monthly copay, and it requires Part D coverage.^[13] TFL members without Part D would have to enroll in it first. The eligibility test and covered drugs are in our Medicare GLP-1 Bridge guide.

For a GLP-1 prescribed for type 2 diabetes, none of this applies. TRICARE says diabetes coverage of Ozempic, Trulicity, Mounjaro and Victoza continues for every plan, TFL included, when prior authorization criteria are met.^[3] Trulicity has the lower copay, and its prior authorization is waived if another diabetes drug appears in your TRICARE pharmacy record in the last 720 days.^[1]

Federal employees: FEHB and PSHB

The Federal Employees Health Benefits program and the Postal Service Health Benefits program work on a different principle. OPM, which runs both, does not leave weight-loss drugs to each plan’s discretion. Since 2023 every carrier has had to list a GLP-1 approved for weight loss plus two or more oral weight-loss drugs, and it has said that carriers may not exclude anti-obesity medicines through a benefit exclusion or carve-out.^[6] Its March 31, 2026 call letter for both programs repeats that floor.^[7]

The same letter tightens the terms for plan year 2027. Coverage must come with an obesity management program built on intensive behavioral therapy, required “prior to and while covering AOM,” and OPM says attestation statements alone of past weight-loss attempts should not bypass the requirement.^[7] For members, that means expecting to document participation in a structured diet, activity and behavior program before approval and to keep doing so while on the drug.

A floor of one GLP-1 does not mean your preferred drug. Each carrier chooses which GLP-1 it covers, at what tier, and with what criteria, and the two largest plans show how much that varies.

FEP Blue

FEP Blue, the Blue Cross and Blue Shield plan for federal workers, has a Wegovy and Saxenda policy that, since February 13, 2026, asks for a body mass index of 30 and up, or 27 and up when the member also has heart or blood-vessel disease or another weight-linked problem (the policy’s examples are type 2 diabetes, high cholesterol and hypertension), and for time in a comprehensive weight management program. Approval lasts six months, and renewal requires keeping at least a 5% loss from baseline.^[8] Its Zepbound policy, effective January 1, 2026, adds two hurdles: an inadequate response to at least two oral weight-loss drugs, and a try of whichever products the plan prefers, unless a medical reason rules that out.^[9]

FEP Blue also says some weight-loss GLP-1s are not covered and can be reached only through a formulary exception, which a prescriber files. If one is approved, Zepbound lands at Tier 3 on FEP Blue Basic and Standard and Tier 2 on FEP Blue Focus, where Wegovy is also Tier 2, and the plan says no tier exception is possible.^[10]

GEHA

GEHA’s coverage sheet, updated October 1, 2026, covers generic liraglutide, Wegovy, Saxenda, Zepbound and Foundayo for weight loss on every plan, all with prior authorization. On its High, Standard, HDHP and Elevate Plus plans the four brands are non-preferred; on Elevate they are preferred.^[11] The tier decides the cost-share, so the same drug can cost a GEHA member very different amounts depending on the plan chosen at Open Season.

If your plan says no

Get the reason in writing. A denial for missing documentation, such as no record of a weight program or of an oral drug tried first, is fixed differently from an exclusion such as TFL’s, which no appeal can change. Our guide to getting a GLP-1 covered sorts the two. When coverage is out of reach, the manufacturers’ cash programs are set out in TrumpRx and manufacturer cash prices.

Common questions