How do I get TRICARE to cover GLP-1 medications?

TRICARE typically requires prior authorization for GLP-1 medications like Ozempic, Wegovy, and Mounjaro. To get coverage, your doctor must submit documentation of medical necessity including your BMI, comorbidities (such as type 2 diabetes or cardiovascular disease), and evidence that other treatments have been tried. TRICARE covers GLP-1 medications through its formulary managed by Express Scripts. Active duty, retirees, and dependents may have different coverage levels. TRICARE has been relatively favorable to GLP-1 coverage.

What should I do if my GLP-1 prior authorization is denied?

If your GLP-1 prior authorization is denied, request a copy of the denial letter with the specific reason for denial. Work with your doctor to prepare an appeal with additional clinical evidence of medical necessity. You can also request a peer-to-peer review between your doctor and the insurer's medical director. Use MedicalRecords.com's Undeniable tool to generate a professional appeal letter.

How long does it take to get prior authorization for GLP-1 medications?

Standard prior authorization decisions are required within 72 hours for urgent requests and within 3-14 days for non-urgent requests, depending on state law and your plan type. Expedited appeals (when delay would seriously jeopardize your health) must be decided within 72 hours. Denials can be appealed through internal and external review processes.

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TRICARE GLP-1 Coverage

TRICARE covers GLP-1 medications through its formulary managed by Express Scripts. Active duty, retirees, and dependents may have different coverage levels. TRICARE has been relatively favorable to GLP-1 coverage.

8/9

Medications Covered

tricare

Plan Type

Ashwin Philips

Reviewed by George T. MathewMDMBAFACP on February 1, 2026

Does TRICARE cover GLP-1 medications like Ozempic and Wegovy?

TRICARE covers 8 of 9 major GLP-1 medications (with prior authorization or directly). TRICARE covers GLP-1 medications through its formulary managed by Express Scripts. Active duty, retirees, and dependents may have different coverage levels. TRICARE has been relatively favorable to GLP-1 coverage. Scroll down for detailed coverage status, copay estimates, denial rates, and appeal success rates for each medication.

Coverage Details

GLP-1 Medications Covered by TRICARE

Ozempic

semaglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$0-$34/month (tier-based)

Denial Rate15-25%

Appeal Success55-65%

Requirements

Type 2 diabetes diagnosis
Metformin trial
TRICARE formulary criteria

TRICARE has favorable GLP-1 coverage with low copays for active duty families.

Wegovy

semaglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate35-45%

Appeal Success35-45%

Requirements

BMI >= 30 or >= 27 with comorbidity
Failed lifestyle modification

TRICARE added Wegovy coverage. Military readiness arguments can strengthen appeals.

Mounjaro

tirzepatide | Eli Lilly

Prior Authorization Required

Typical Copay$0-$34/month

Denial Rate20-30%

Appeal Success50-60%

Requirements

Type 2 diabetes diagnosis
TRICARE formulary criteria

Good TRICARE coverage for diabetes.

Zepbound

tirzepatide | Eli Lilly

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate35-45%

Appeal Success30-40%

Requirements

BMI >= 30 or >= 27 with comorbidity

TRICARE considering expanded weight management coverage.

Rybelsus

semaglutide (oral) | Novo Nordisk

Prior Authorization Required

Typical Copay$0-$25/month

Denial Rate15-20%

Appeal Success60-70%

Requirements

Type 2 diabetes diagnosis

Available through military pharmacies with low copays.

Saxenda

liraglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate40-50%

Appeal Success25-35%

Requirements

BMI >= 30 or >= 27 with comorbidity

Available but being replaced by weekly options.

Trulicity

dulaglutide | Eli Lilly

Covered

Typical Copay$0-$25/month

Denial Rate5-10%

Appeal Success70-80%

Requirements

Type 2 diabetes diagnosis

Preferred on TRICARE formulary.

Victoza

liraglutide | Novo Nordisk

Covered

Typical Copay$0-$25/month

Denial Rate5-10%

Appeal Success70-80%

Requirements

Type 2 diabetes diagnosis

Established TRICARE coverage.

Compounded Semaglutide

semaglutide (compounded) | Various Compounding Pharmacies

Not Covered

Typical CopayN/A

Denial Rate100%

Appeal Success0%

Not covered by TRICARE.

Prior Authorization

TRICARE Prior Authorization Process

Submit through Express Scripts military pharmacy portal. Standard review within 5 business days. Military treatment facilities may have direct access.

Appeals

How to Appeal a TRICARE GLP-1 Denial

Reconsideration through Express Scripts. Formal appeal to TRICARE regional contractor. TRICARE Pharmacy Operations review as final level.

Contact Information

Express Scripts: 1-877-363-1303 | TRICARE: 1-800-444-5445

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Disclaimer

Coverage information for TRICARE is based on publicly available formulary data and general plan information. Your specific plan may differ significantly. Always verify coverage directly with TRICARE before starting treatment.

Related resources

TRICARE GLP-1 Coverage

8/9

Medications Covered

tricare

Plan Type

Ashwin Philips

Reviewed by George T. MathewMDMBAFACP on February 1, 2026

Does TRICARE cover GLP-1 medications like Ozempic and Wegovy?

Coverage Details

GLP-1 Medications Covered by TRICARE

Ozempic

semaglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$0-$34/month (tier-based)

Denial Rate15-25%

Appeal Success55-65%

Requirements

Type 2 diabetes diagnosis
Metformin trial
TRICARE formulary criteria

TRICARE has favorable GLP-1 coverage with low copays for active duty families.

Wegovy

semaglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate35-45%

Appeal Success35-45%

Requirements

BMI >= 30 or >= 27 with comorbidity
Failed lifestyle modification

TRICARE added Wegovy coverage. Military readiness arguments can strengthen appeals.

Mounjaro

tirzepatide | Eli Lilly

Prior Authorization Required

Typical Copay$0-$34/month

Denial Rate20-30%

Appeal Success50-60%

Requirements

Type 2 diabetes diagnosis
TRICARE formulary criteria

Good TRICARE coverage for diabetes.

Zepbound

tirzepatide | Eli Lilly

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate35-45%

Appeal Success30-40%

Requirements

BMI >= 30 or >= 27 with comorbidity

TRICARE considering expanded weight management coverage.

Rybelsus

semaglutide (oral) | Novo Nordisk

Prior Authorization Required

Typical Copay$0-$25/month

Denial Rate15-20%

Appeal Success60-70%

Requirements

Type 2 diabetes diagnosis

Available through military pharmacies with low copays.

Saxenda

liraglutide | Novo Nordisk

Prior Authorization Required

Typical Copay$25-$75/month

Denial Rate40-50%

Appeal Success25-35%

Requirements

BMI >= 30 or >= 27 with comorbidity

Available but being replaced by weekly options.

Trulicity

dulaglutide | Eli Lilly

Covered

Typical Copay$0-$25/month

Denial Rate5-10%

Appeal Success70-80%

Requirements

Type 2 diabetes diagnosis

Preferred on TRICARE formulary.

Victoza

liraglutide | Novo Nordisk

Covered

Typical Copay$0-$25/month

Denial Rate5-10%

Appeal Success70-80%

Requirements

Type 2 diabetes diagnosis

Established TRICARE coverage.

Compounded Semaglutide

semaglutide (compounded) | Various Compounding Pharmacies

Not Covered

Typical CopayN/A

Denial Rate100%

Appeal Success0%

Not covered by TRICARE.

Prior Authorization

TRICARE Prior Authorization Process

Submit through Express Scripts military pharmacy portal. Standard review within 5 business days. Military treatment facilities may have direct access.

Appeals

How to Appeal a TRICARE GLP-1 Denial

Reconsideration through Express Scripts. Formal appeal to TRICARE regional contractor. TRICARE Pharmacy Operations review as final level.

Contact Information

Express Scripts: 1-877-363-1303 | TRICARE: 1-800-444-5445

TRICARE GLP-1 denied? Our AI appeal tool can help.

Start Your Appeal Learn About Appeals

GLP-1 Medication Denied by Insurance?

You have the right to appeal. Our AI-powered appeal tool generates professional appeal letters with PubMed-cited evidence in minutes.

Start Your Free Appeal Appeal Guide