Retired E-7, 22 years in, now on Tricare Select. My PCM at the base clinic recommended Wegovy back in October but said the military formulary situation is "complicated." She wasn't wrong.
I've been going back and forth with the Tricare pharmacy for three months. They say Wegovy requires a prior auth through Express Scripts Federal, which requires documentation from a TRICARE-authorized weight management program. The closest one to me (outside San Diego) has a 6-month waitlist.
BMI 36, sleep apnea, hypertension, prediabetes. Twenty-two years of MREs and midnight watches did a number on me. Can any military folks share what actually worked for getting GLP-1 coverage through Tricare?
Military spouse and nurse here, been through this with both my husband (active duty) and my father-in-law (retired). The Tricare GLP-1 situation as of early 2026:
What's on the Tricare formulary:
- Ozempic (semaglutide for T2D) — Tier 2, covered with PA. Copay: $0 at MTF pharmacy, $14 at retail network pharmacy on Tricare Prime, $28 on Tricare Select.
- Mounjaro (tirzepatide for T2D) — Tier 3, covered with PA. Similar copays.
- Wegovy (semaglutide for weight management) — this is the problem child. It's on the Uniform Formulary but classified as a "non-covered benefit" when prescribed solely for obesity. Covered only with T2D diagnosis.
- Zepbound — same as Wegovy, non-covered for weight management.
The workaround: if you have prediabetes with A1C ≥ 5.7, many Tricare PCMs will prescribe Ozempic off-label for "glucose management with weight reduction as secondary benefit." Express Scripts has been approving these PAs pretty consistently.
Active duty Army here at lisa_labSD (Liberty, whatever). I'll share what worked for me because it took some creativity:
Got put on the Army Body Composition Program (ABCP) after failing tape twice. My battalion PA referred me to the Womack MEDDAC endocrine clinic. The endocrinologist there prescribed Ozempic 1mg — not Wegovy — under my prediabetes diagnosis (A1C 5.9).
Filled at the MTF pharmacy for $0. Zero copay. The key was going through the military treatment facility pharmacy, not a retail pharmacy. MTF pharmacies don't charge copays for formulary meds and the PA process is handled internally — way faster than going through Express Scripts.
I'm down 31 lbs in 5 months and passed tape last month. My company commander doesn't care how I did it, just that I'm in standard.
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Shop Reference StandardsThis is really helpful. So if I'm understanding correctly, the play is:
- Get Ozempic instead of Wegovy
- Have it prescribed for prediabetes/metabolic, not "weight management"
- Fill at the MTF pharmacy if possible for $0 copay
My A1C last check was 6.1, so prediabetes is legit. But I'm on Tricare Select, not Prime — can I still use the MTF pharmacy? I'm near NMCSD but I'm not enrolled there for primary care.
Tricare Select retirees CAN use MTF pharmacies, but it's on a space-available basis. You won't get priority over active duty and Prime beneficiaries, and not all MTF pharmacies stock Ozempic consistently (supply issues are real).
Your better bet on Select: get the Ozempic PA through Express Scripts for prediabetes, then fill at a Tricare retail network pharmacy. Your copay will be $28 for a 90-day supply at a network pharmacy, or $14 through the Express Scripts mail-order pharmacy. That's $14 every 90 days. Basically nothing.
Call Express Scripts Federal at 1-877-363-1303 and ask them to start the PA. Have your doctor send documentation of your A1C, BMI, comorbidities. Turnaround is usually 5-7 business days.