Changes to your TRICARE pharmacy benefit

Changes to your TRICARE pharmacy benefit impacting weight loss medication(s) will go into effect August 31, 2025. The Defense Health Agency has implemented regulatory controls that affect how TRICARE covers weight loss medication. TRICARE only covers weight loss medication(s) for TRICARE Prime and TRICARE Select when obesity is the sole or major condition treated.1

What is changing?

If you have TRICARE Prime or TRICARE Select, these medications are still covered with a previously approved prior authorization.

If you are not a TRICARE Prime or TRICARE Select beneficiary, and you previously had an approved prior authorization for weight loss drugs, it’s no longer valid. You will need to see your provider to discuss your options.

Glucagon-Like Peptide 1 (GLP-1s) for the treatment of type 2 diabetes continues to be covered for all patients with a diagnosis of diabetes when prior authorization requirements are met. Cost-shares for these medications remain unchanged.

What is prior authorization?

Certain prescriptions require prior authorization. You may need prior authorization for your prescription if it:

• Is specified by the DOD Pharmacy & Therapeutics Committee
• Is a brand-name prescription drug with a generic substitute
• Has age limits
• Is prescribed for an amount more than the normal limit
• Check your prescription drug cost and coverage and to inquire about prior authorization requirements by searching the TRICARE Formulary Search Tool

How do I know which TRICARE plan I'm enrolled in?
DEERS (Defense Enrollment Eligibility Reporting System) is used to determine your TRICARE eligibility. You can check your current enrollment status at milConnect or by calling your regional contractor. Contact information can be found in the Helpful Resources below.

Helpful Resources:

• The TRICARE Formulary is a list of generic and brand-name prescription drugs that we cover. TRICARE covers most prescription drugs approved by the U.S. Food and Drug Administration (FDA).
• Check your TRICARE eligibility and current enrollment at:
  • milConnect
  • Humana Military (TRICARE East Region): 800-444-5445
  • TriWest Healthcare Alliance (TRICARE West Region): 888-874-9378
  • DEERS: 1-800-538-9552

I have diabetes and am taking GLP-1 medication. Will my medication still be covered?
Yes, if your medication is FDA indicated and prescribed for type 2 diabetes, coverage will continue with approved prior authorization. Note: GLP-1s are not prescribed for type 1 diabetes.

Who should I contact if I have questions?

If you have any questions about your TRICARE pharmacy benefit, please call Express Scripts at 877.363.1303.

Learn more about the coverage of weight loss management medications here.

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  Under the authority of Section 199.17(f)(3) of Title 32, Code of Federal Regulations.