TRICARE For Life does not cover weight loss drugs. As of August 31, 2025, the Defense Health Agency ended coverage of medications prescribed to treat obesity for TFL beneficiaries and invalidated every prior authorization that was already in place.1 If you want to keep taking a drug like Wegovy or Zepbound for weight loss, you now pay the full retail price yourself.
What Ended on August 31, 2025
The Defense Health Agency described the change as applying “existing regulatory controls” to align TRICARE pharmacy processing with federal coverage rules. In practice, active prior authorizations held by TFL beneficiaries became invalid overnight, and military pharmacies stopped filling weight loss prescriptions for this group.
The drugs affected include Wegovy, Zepbound, Saxenda, Qsymia, phentermine, and Contrave. Express Scripts, which administers the TRICARE pharmacy program, mailed notification letters to affected beneficiaries on July 31, 2025.
The cutoff hit a few smaller groups too: beneficiaries with direct care only access, those with NATO or Partnership for Peace status, and TRICARE Plus enrollees.
GLP-1s Are Still Covered for Diabetes
The exclusion turns on why the drug is prescribed. TRICARE, including TFL, continues to cover several GLP-1 medications when they are used to treat Type 2 diabetes: Ozempic, Trulicity, Mounjaro, and Victoza. Prior authorization is required, and some prescriptions need a medical necessity form for formulary copay rates or military pharmacy dispensing. Copayments for these diabetes prescriptions have not changed.
One boundary matters here. Medicare Part D may cover GLP-1 drugs for related uses such as cardiovascular risk reduction or obstructive sleep apnea. TFL does not follow Medicare on that point. Even if your provider prescribes Wegovy or Zepbound for a cardiovascular indication rather than for weight loss, TFL’s regulatory framework does not authorize coverage of medications whose purpose is to control or reduce weight.
Why TFL Is Treated Differently From Prime and Select
Active-duty families and younger retirees on TRICARE Prime or TRICARE Select can still get weight loss drugs covered if they meet clinical criteria and secure a prior authorization. TFL beneficiaries cannot. The Defense Health Agency traces this split to two different regulations.
The general exclusion is at 32 CFR § 199.4, which prohibits TRICARE from covering “medications intended to control or reduce weight.” Edward C. Norton, Chief of the Pharmacy Operations Division at the Defense Health Agency, said TFL coverage of weight loss drugs “isn’t authorized when obesity is the sole or major condition treated,” and that this holds regardless of co-morbid conditions or the patient’s age.
Prime and Select operate under statutes that let the Department of Defense add preventive care benefits, which is how obesity treatment coverage reaches those plans through network providers. TFL is Medicare wraparound coverage governed by 32 CFR § 199.17, and the agency’s position is that this framework does not authorize the same obesity benefit. Critics have called the result a two-tier pharmacy benefit for people who earned coverage through the same military service.
What You Can Do If You’re on TFL
Options are limited. There are three.
Pay out of pocket. TFL beneficiaries who want to keep taking Wegovy, Zepbound, or a similar drug for weight loss must cover the full retail cost, which for GLP-1 medications can run over $1,000 per month depending on the drug and pharmacy. Military pharmacies will not fill these prescriptions for TFL beneficiaries at any price.
Watch the Medicare GLP-1 Bridge in 2026. The Centers for Medicare and Medicaid Services launched a temporary nationwide demonstration, the Medicare GLP-1 Bridge, that runs from July 1 through December 31, 2026, and provides access to Wegovy and Zepbound for weight reduction at a $50 copay. Eligibility requires enrollment in a standalone Medicare Part D prescription drug plan or a Medicare Advantage plan with drug coverage. TFL beneficiaries generally do not enroll in Part D because TFL already provides pharmacy coverage, and the program’s published guidance does not directly address whether a TFL beneficiary who separately enrolled in Part D could use the Bridge. A longer-term program, the BALANCE Model, is scheduled to begin covering GLP-1s for obesity under Medicare Part D in January 2027, though it requires 80% participation from Part D plan sponsors and is set to expire in December 2031.
Ask about bariatric surgery. TRICARE does cover bariatric surgery for TFL beneficiaries who meet strict criteria: a BMI of 40 or higher, or a BMI between 35 and 39.9 with at least one significant comorbidity such as cardiovascular disease, Type 2 diabetes, sleep apnea, or hypertension. Covered procedures include gastric bypass, sleeve gastrectomy, and adjustable gastric banding, among others. TRICARE does not cover non-surgical obesity treatments such as nutritional counseling, commercial weight loss programs, or physician-supervised programs that consist only of medication management.
Legal Challenge and What Congress Might Do
A retired Air Force colonel and attorney, Derence Fivehouse, sued the Department of Defense on August 29, 2025, one day before the cutoff. The case, Fivehouse v. U.S. Department of Defense (2:25-cv-00041), is pending in the U.S. District Court for the Eastern District of North Carolina. Fivehouse argues that excluding GLP-1 weight loss drugs from TFL violates the Administrative Procedure Act, is contrary to law, exceeds the Department’s authority, and is arbitrary and capricious.
Attempts to halt the policy while the case proceeds have not succeeded. Chief Judge Richard Ernest Myers II denied a temporary restraining order on August 29, 2025, finding no irreparable harm. A motion for reconsideration was denied on September 9, and an initial motion for a preliminary injunction was denied without prejudice on September 17 for improper service. A renewed motion for preliminary injunction went to Magistrate Judge Robert T. Numbers II, who recommended denial in a November 13, 2025 memorandum, again on irreparable-harm grounds. The underlying case remained active as of mid-2026.
On the legislative side, no bill or National Defense Authorization Act amendment restoring weight loss drug coverage for TFL has been enacted. The Military Officers Association of America has pushed the issue as one of benefit equity, arguing that affected beneficiaries had documented comorbid conditions and met prior authorization standards, and has identified the House markup of the FY 2027 NDAA and the Senate proceedings that follow as the next opportunities to add such a provision. An October 2025 Federal Register notice on TRICARE program changes for calendar year 2026 confirmed that TFL remains excluded from weight loss drug coverage, while Prime and Select coverage continues under significantly revised prior authorization forms aimed at preventing fraud, waste, and abuse.
Until Congress or the courts change the rule, the answer for TFL is the one the Defense Health Agency gave on August 31, 2025.