Military health benefit. Coverage practices set by TRICARE pharmacy and therapeutics committee.
Type 2 diabetes coverage
Covered for T2D. Typical copay $0–$15/mo for retail prescriptions.
Weight management coverage
Variable. TRICARE has expanded Wegovy/Zepbound coverage under specific criteria but remains restrictive.
CV indication coverage
Coverage of Wegovy under March 2024 CV indication expanding.
OSA indication coverage
Coverage of Zepbound for OSA expanding.
Prior authorization (typical)
Similar to commercial: BMI thresholds, comorbidity, documented lifestyle modification.
How to verify
Call member services on your card and ask: (1) Is [Wegovy/Zepbound/Ozempic/Mounjaro] on my formulary? (2) What tier? (3) PA criteria? (4) Expected copay? Document the date, rep's name, and any reference number.
Cash-pay alternative
If insurance is unworkable, see our price index. Our editor's pick NexLife runs $145–$215/mo flat-rate.