Tricare GLP-1 coverage for military families — updated policy

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.

This is really helpful. So if I'm understanding correctly, the play is:

1. Get Ozempic instead of Wegovy
2. Have it prescribed for prediabetes/metabolic, not "weight management"
3. 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.