GLP-1s for Service Members and Veterans: Rules, Drug Tests, Coverage

Service members, including the Guard and Reserve, can use an FDA-approved GLP-1 drug such as Wegovy or Zepbound with a prescription. Operation Supplement Safety (OPSS), a Defense Department program, says to decide first with your military medical officer or primary care manager, warns that use during training or deployment might not be allowed, and tells service members to avoid compounded GLP-1 drugs. If you fly, ask your flight surgeon. Ozempic and Mounjaro are approved for type 2 diabetes, not weight loss.^{1, 2, 3, 4, 5}

Drug tests: these drugs are not controlled substances, and DoD's 2018 and 2023 descriptions of its testing panel don't list them. If you serve, make sure the prescription is in your military health record, as OPSS advises.^{1, 6, 7, 8, 9}

Coverage: as of October 3, 2026, TRICARE Prime, Select and the premium plans that carry their benefits, such as Reserve Select, cover Wegovy, Zepbound and Saxenda for weight loss with prior authorization (approval in advance); TRICARE For Life does not. The VA can prescribe Wegovy, Zepbound or Foundayo through a special request if you meet its criteria. They start with a BMI of 27 or more with a weight-related condition and documented time in a lifestyle program. VA copays run $0 to $11 for a 30-day supply.^{10, 11, 12, 13, 14, 15, 16}

Find your group:

• Serving now: active duty, Guard or Reserve
• Facing a military drug test
• Offered a compounded drug, a "research" peptide or a supplement
• Applying to join
• Starting one of these drugs
• Families, retirees and reservists on TRICARE, including TRICARE For Life
• Veterans using VA care, and families on CHAMPVA

If you serve now: active duty, Guard or Reserve

OPSS posted its GLP-1 advice on June 3, 2026, for all service members. The National Guard and Reserve are reserve components of the armed forces.^{1, 2, 17}

Its advice, step by step:¹

1. See your military medical officer or primary care manager (PCM) first. If you have obesity, or are overweight with other risk factors, decide together whether a GLP-1 is right for you.
2. Use your military hospital or clinic when you can; its providers know your service's GLP-1 rules best. A civilian doctor, such as one you see as a Guard or Reserve member, may prescribe weight-loss medicines but should know how TRICARE decides coverage.
3. Get every medicine into your electronic military health record, including one a civilian doctor prescribes.
4. Check duty limits before you start. Use in training, deployments or on operational platforms might not be authorized, though it might be allowed case by case. Service and duty policies "remain under review and are subject to change." This page doesn't cover DoD's retention or deployment-limiting standards, so ask your command's medical officer what applies to you (aircrew: see below).
5. Avoid compounded and investigational GLP-1 drugs (see compounded drugs and "research" peptides).

If you already take one. If a civilian or online prescriber started you on a GLP-1, or you use a compounded one, tell your PCM or military medical officer and ask about an FDA-approved option (for compounded tirzepatide, see how a switch to Zepbound works).¹ Don't stop or change a prescribed medicine without talking to a prescriber.

Service rules differ. For active-duty members, the joint VA/DoD obesity guideline (September 2025) says no overarching DoD or Defense Health Agency instruction on obesity treatment exists, and sums up the services this way:¹⁸

• Air Force: limits how long obesity medicines can be prescribed.
• Army: bars any medicine used "solely for its anorexic activity," meaning only to curb appetite, in Army hospitals and clinics, but does not address obesity treatment. Ask your PCM how that applies to GLP-1s and to the older appetite suppressants on TRICARE's checklist.^{18, 19}
• Navy and Marine Corps: no formal restrictions.

Storage on the move. For active-duty members, the guideline counts storage needs among the factors a provider weighs, with your job, deployment status, side effects, duty limits and readiness.¹⁸ Each form has its own label rule:^{6, 7, 20}

• Wegovy single-dose pen: refrigerate; if needed, up to 28 days at 46°F to 86°F in its carton before the cap comes off.
• Wegovy FlexTouch pen (four weekly doses): refrigerate until first use, then up to 56 days at 59°F to 86°F or refrigerated.
• Zepbound single-dose pen or vial: refrigerate; if needed, up to 21 days in total unrefrigerated at 86°F or below.
• Zepbound KwikPen or multi-dose vial (four weekly doses): refrigerate. Throw it away after 30 days at room temperature (up to 86°F), opened or not, or once in use after 30 days or 4 doses, whichever comes first.
• Wegovy tablets and Foundayo: room temperature, 68°F to 77°F. Keep Wegovy tablets in their original closed bottle.

Never share any GLP-1 pen, even with a new needle, because sharing can spread blood-borne infections. With Zepbound vials, use a new syringe and needle for every injection and never share them. Express Scripts' Deployment Prescription Program won't ship medicines that need refrigerated packing to APO, FPO or DPO (military mail) addresses.^{4, 5, 6, 7, 21, 22, 23}

Aircrew. A November 2025 review in the journal Military Medicine says aircrew members are not authorized to use FDA-approved weight-loss medicines, because of concerns about physical effects and the risk of incapacitation. It is a journal article, not a policy, so ask your flight surgeon, or the medical officer for any other special duty you hold.³

TRICARE on active duty. An active-duty request goes first to Express Scripts, TRICARE's pharmacy contractor, even if it won't meet the criteria. Your military hospital or clinic can then reconsider it, and prescribers must follow your military department's weight-program rules (see the form's checklist).²⁴

Covered drugs cost active-duty members $0 at military pharmacies, network pharmacies and TRICARE Home Delivery. Call a military pharmacy ahead to check it stocks your drug. Guard and Reserve members on TRICARE Reserve Select are covered too (see the TRICARE table).^{10, 25, 26}

Will a GLP-1 show up on a military drug test?

DoD tests for drugs of abuse. A 2018 DoD briefing listed marijuana, cocaine, methamphetamine and amphetamines, MDMA (ecstasy), heroin, synthetic cannabinoids, and prescription opioids and benzodiazepines. A 2023 briefing listed later additions: fentanyl (fiscal 2019), LSD again (fiscal 2020) and delta-8-THC (fiscal 2021).^{8, 9}

DoD aligned the panel used at military entrance processing stations (MEPS) with the military's in fiscal 2017. Guard and Reserve members are tested too: the 2018 briefing reports positive rates for those not on active status.⁸

Wegovy, Zepbound, Ozempic, Mounjaro and Foundayo are not federally controlled substances. DailyMed lists each as "DEA Schedule: None," and we found no DoD document naming GLP-1 drugs as a testing target. That is not a promise about any test.^{4, 5, 6, 7, 8, 9, 20} If you use a compounded GLP-1, OPSS's concern is the product itself (see if you already take one).¹

The older drugs TRICARE asks for are different. TRICARE's form asks most adults to try one of four older appetite suppressants, such as phentermine, for 3 months first. All four are federally controlled (Schedule III or IV) and chemically related to amphetamines, which the program tests for.^{24, 27, 28, 29, 30}

OPSS said in March 2025 that phentermine might register on a first urine screen for amphetamines. The sample then goes to a confirmation test, where phentermine won't cause a positive result or be reported as positive by the military drug-testing program.³¹ That note covers phentermine only, so with any of the four, make sure the prescription is in your record. Their label warnings are with TRICARE's form.

Which GLP-1 drugs are approved for weight loss, and which for diabetes

Four are approved for weight management: Wegovy (semaglutide), Zepbound (tirzepatide), Saxenda (liraglutide) and Foundayo (orforglipron), a daily pill. Each is approved, together with a reduced-calorie diet and more exercise, for adults who have obesity, or overweight plus at least one weight-related condition. Wegovy injection and Saxenda are also approved for some children 12 and older with obesity (for Saxenda, those over 60 kg).^{6, 7, 20, 21}

Some have other approved uses, again with diet and exercise. Zepbound treats moderate to severe obstructive sleep apnea in adults who have obesity. Wegovy injection and tablets lower the risk of heart attack, stroke and death from heart or blood vessel disease in adults who already have cardiovascular disease and either obesity or overweight.^{6, 7}

Wegovy injection also has an accelerated approval for MASH, a form of fatty liver disease with inflammation and liver damage that can lead to scarring. It covers adults with moderate to advanced scarring (stage F2 or F3) but not cirrhosis, and it may depend on a confirming trial.⁶

Ozempic (semaglutide), Mounjaro (tirzepatide), Trulicity (dulaglutide) and Victoza (liraglutide, the medicine in Saxenda) are diabetes drugs. They are approved with diet and exercise to improve blood sugar control in type 2 diabetes in adults and, for Mounjaro, Trulicity and Victoza, from age 10. Taking one only to lose weight is off-label, and TRICARE, the VA and CHAMPVA cover them only for type 2 diabetes.^{4, 5, 10, 22, 32, 33, 34, 35}

If none of these uses fits you and you serve, raise it with your PCM. Otherwise, take it to your VA primary care team or your own doctor, who already have your records. Online sellers, PlexusDx among them, are not a route around these approved uses: any other use is off-label, whoever writes the prescription. GLP-1s if you're not obese or overweight explains off-label use; label warnings are under side effects to plan for.

Compounded GLP-1s, "research" peptides and supplements

If you serve. OPSS is direct: "Service Members should avoid using compounded and investigational GLP-1 drugs as they pose severe risks to military health and readiness." It adds that, unlike FDA-approved medications such as Wegovy, Ozempic and Zepbound, "compounded alternatives lack agency review for safety, quality, and efficacy."¹

That advice covers PlexusDx's compounded GLP-1 programs too, and PlexusDx publishes this page. So if you serve, on active duty or in the Guard or Reserve, don't get a GLP-1 through PlexusDx or any other compounded program. Follow OPSS's steps above to get an FDA-approved one from a military provider or a civilian doctor who knows TRICARE's rules.¹

What FDA says. Compounded semaglutide and tirzepatide are not FDA-approved, and FDA doesn't review compounded drugs for safety, effectiveness or quality before they're marketed. It says they should be used only when a patient's medical needs can't be met by an FDA-approved drug, and its guidance on compounded copies of approved drugs says a lower price isn't a reason.^{36, 37}

A TRICARE, VA or CHAMPVA denial, or TRICARE For Life's legal exclusion, decides who pays. It is not a medical reason, so it doesn't justify a compounded drug either. If TRICARE or the VA will cover an FDA-approved GLP-1 for you, that route usually costs a copay at a military pharmacy, a network pharmacy, TRICARE Home Delivery or the VA (see TRICARE and VA care); if no plan will, see paying cash.

As of May 31, 2026, FDA had 990 adverse-event reports associated with compounded semaglutide and more than 730 with compounded tirzepatide. That is likely an undercount, because state-licensed pharmacies that aren't outsourcing facilities don't have to report them. FDA says many look like the approved drugs' side effects. So for a compounded product too, go through the label warnings, including who must not take these drugs, with any prescriber (see side effects to plan for).³⁶

Some reports, including hospital stays, were possibly related to dosing errors with compounded semaglutide injections, by patients measuring their own doses or clinicians miscalculating them.³⁶ If you don't serve and are weighing a compounded provider, run our checks first (PlexusDx's own answers are in the same guide); our compounding explainer covers the legal limits.

Trial drugs, "research" peptides and supplements. Drugs still in clinical trials for obesity may be marketed for weight loss, but OPSS says they aren't approved by FDA for any use and are legal only for people in clinical trials. FDA has warned companies that illegally sold semaglutide, tirzepatide and trial drugs labeled "for research purposes" or "not for human consumption," and urges consumers not to buy them (see when to walk away from a seller). "GLP-1 supplements" are not GLP-1 drugs; OPSS says they contain supplement ingredients instead.^{1, 36}

PlexusDx, which publishes this page, also sells supplement packs, among them one named Weight Loss Support that contains berberine, green tea extract and ForsLean (Coleus forskohlii); those aren't GLP-1 drugs either.

PlexusDx and FDA's test. PlexusDx's programs face the same test. Lone Star Virtual Health says the justification has to be personal: its physicians document why the compounded version suits that individual better than Wegovy, Zepbound or another approved drug, explain it to them, and say plainly that compounded medicines are not FDA-approved. Any part of that justification resting on B12, B6 or glycine must match the person's clinical needs.

PlexusDx does not practice medicine. Clinicians from Lone Star Virtual Health, the medical group that provides PlexusDx's clinicians, review each person's health history and decide whether to prescribe, and licensed partner pharmacies dispense the prescriptions. PlexusDx does not sell or ship brand-name medications. If you would prefer a brand-name, FDA-approved medication, your provider may write a prescription you can fill at the pharmacy of your choice.

The programs are for adults 18 and older. To be considered, your BMI must be at least 25, or at least 22 if a GLP-1 drug was part of your treatment within the past two months; the same rules apply to all three PlexusDx GLP-1 plans, and Lone Star's physicians decide. Below a BMI of 30, or of 27 for someone with a weight-related condition, Wegovy and Zepbound are not approved for starting weight-loss treatment, so a first prescription there would be off-label. The intake asks about eating disorders, gallbladder disease, MEN 2 in the family and diabetes medicines, among others, but not about diabetic retinopathy, an operation or sedation you have scheduled, or a B12 or glycine allergy, so bring those up yourself. Lone Star's live-visit rules by state are in our provider guide. The approved semaglutide and tirzepatide labels set out who must not take these drugs; see side effects to plan for.

As of October 19, 2026, PlexusDx's programs are self-pay, and PlexusDx bills no health insurance, including TRICARE (see PlexusDx's Terms of Service). So a prescription written through PlexusDx would not meet TRICARE's rule for U.S. coverage, which requires a military provider or a network provider who has billed TRICARE for your visit. VA coverage runs through a request from your VA provider, and CHAMPVA doesn't cover these drugs for weight loss.^{24, 35, 38}

If you also get VA, TRICARE or military care, tell those clinicians about any GLP-1 you get elsewhere. They can then check for a second GLP-1, adjust insulin or a sulfonylurea (a type of diabetes pill) and plan around procedures.

Applying to join: what DoD's medical standards say

DoD's medical standards for joining (DoD Instruction 6130.03, Volume 1, as changed February 3, 2026) do not name GLP-1 drugs or weight-loss medicines.³⁹

One general rule covers injected GLP-1s such as Wegovy injection, Zepbound, Ozempic and Mounjaro, though it doesn't name them. Current use of a medicine given by injection or skin patch, or one that needs refrigeration, is disqualifying. The exception is written confirmation from your treating provider that it can be safely paused, stopped or switched to another form for times when that form, or refrigeration, isn't available or allowed during training or deployment.³⁹

The conditions these drugs treat appear too. A history of diabetes, unresolved prediabetes within the last 24 months, metabolic syndrome and any past bariatric (weight-loss) surgery are listed as disqualifying. Applicants who don't meet a standard can be considered for a waiver, except for conditions DoD lists as ineligible.³⁹

Applicants must disclose their full medical history, name their insurer and past providers, and let DoD request their records, including from pharmacies. What you report counts as an official statement.³⁹ So tell your recruiter about any GLP-1 you take or have taken, bring your prescription records and ask how they will be reviewed. Whether a drug test looks for these medicines doesn't answer that question.

Decisions about starting, stopping or switching a medicine belong with the provider who prescribes it.

Side effects to plan for

The boxed warning. FDA's strongest warning on these labels concerns thyroid C-cell tumors. Semaglutide, tirzepatide, liraglutide and dulaglutide caused them in rats or mice. Orforglipron, the drug in Foundayo, doesn't act on the GLP-1 receptor in rats or mice, so those studies couldn't show whether it causes them. It does act on the human GLP-1 receptor, and its label says the human relevance of the tumors seen in rodents has not been determined.^{4, 5, 6, 7, 20, 21, 22, 32}

Whether any of these drugs, Foundayo included, causes these tumors in people, including medullary thyroid carcinoma (MTC), a thyroid cancer, is not known. Every one of these labels carries the boxed warning. Don't take one if you or a family member has had MTC, if you have multiple endocrine neoplasia syndrome type 2 (MEN 2), or after a serious allergic reaction to the drug or anything in it. The labels also advise against them in severe gastroparesis, where the stomach empties very slowly, and Foundayo's adds severe liver impairment.^{4, 5, 6, 7, 20, 21, 22, 32}

Stomach, pancreas and gallbladder. Stomach and bowel side effects can be severe, and the fluid they cost can injure the kidneys, sometimes badly enough to need dialysis, so drink fluids. Pancreatitis (an inflamed pancreas) has caused deaths in severe cases. Gallbladder problems, such as gallstones, happen more often than with placebo, and some need surgery.^{4, 5, 6, 7, 20, 21, 22, 32}

These drugs can cause low blood sugar, most often with insulin or a sulfonylurea. Labels for Wegovy, Zepbound and Foundayo also describe it in adults without type 2 diabetes, and Saxenda's in children 12 and older without diabetes. If you have type 2 diabetes, report vision changes: the Wegovy, Zepbound, Foundayo, Ozempic, Mounjaro and Trulicity labels warn about diabetic eye problems. Wegovy and Saxenda may also raise your resting heart rate.^{4, 5, 6, 7, 20, 21, 32}

Before dental work, surgery or sedation. In rare cases, people on these drugs have breathed stomach contents into their lungs under general anesthesia or deep sedation. Before any planned procedure, tell every provider you take one, including a military or VA dentist.^{6, 7}

With other medicines. Don't double up: the Wegovy, Zepbound, Foundayo and Saxenda labels advise against taking them with any other GLP-1 medicine, and compounded semaglutide or tirzepatide counts too. Because these drugs slow stomach emptying, pills you swallow may be absorbed differently; Zepbound's label names warfarin as one to watch.^{6, 7, 20, 21} Tell your prescriber about every medicine and supplement you take, including herbal ones.^{1, 6, 7, 20, 21}

Foundayo's label warns against some medicines that strongly speed up or block a liver enzyme called CYP3A4, such as ritonavir, and caps the simvastatin dose. In a study, levels of levothyroxine, a thyroid medicine, rose about a third when taken with semaglutide tablets. If you take it, tell your prescriber, who may monitor it more closely.^{6, 20}

Pregnancy and birth control. The Wegovy, Zepbound, Foundayo and Saxenda labels say to stop the drug when a pregnancy is recognized (for Wegovy, when used for weight or heart risk). They, and the Ozempic, Mounjaro, Trulicity and Victoza labels (from animal studies), warn of possible harm to a developing baby. Wegovy's and Ozempic's labels say to stop at least 2 months before you try to become pregnant. With Wegovy for MASH, decide that with your prescriber.^{4, 5, 6, 7, 20, 21, 22, 32}

The Ozempic, Mounjaro, Trulicity and Victoza labels, and Wegovy's for MASH, allow use in pregnancy only if the potential benefit justifies the risk to the baby. If you take one of them and become pregnant, or plan to, tell your prescriber right away instead of simply stopping. Breastfeeding is not recommended with Wegovy tablets or Foundayo.^{4, 5, 6, 20, 22, 32}

With birth-control pills, the Zepbound and Mounjaro labels say to switch to a method that isn't a pill, or add a barrier method, for 4 weeks after you start and after every dose increase. Foundayo's label says 30 days and advises effective birth control during treatment for anyone who could become pregnant.^{5, 7, 20}

Signs that need action, from Zepbound's Medication Guide (the other guides list similar ones):⁷

• Severe stomach pain that won't go away, with or without nausea or vomiting, sometimes reaching your back: stop the drug and call your prescriber right away.
• Swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or a very fast heartbeat: stop using it and get medical help right away.
• Upper stomach pain, fever, yellowing of the skin or eyes, or clay-colored stools (possible gallbladder trouble): tell your prescriber right away.
• Nausea, vomiting or diarrhea that won't stop: tell your prescriber right away, and drink fluids.
• Dizziness, sweating, confusion, shakiness or a fast heartbeat (possible low blood sugar): learn these signs, and ask your prescriber what to do if they happen.
• A lump or swelling in your neck, hoarseness, difficulty swallowing or being short of breath: tell your prescriber.
• Took too much: call Poison Help at 1-800-222-1222 or your prescriber, or go to the nearest emergency room right away.

TRICARE coverage, group by group

Where the table says yes, you also need TRICARE's clinical criteria (see the checklist below) and prior authorization. Saxenda also needs a medical necessity form.¹⁰

Overseas. The plans are Prime Overseas, Prime Remote Overseas, Select Overseas, Reserve Select, Retired Reserve and Young Adult. You need an obesity diagnosis, age and BMI that meet the criteria, a weight-management plan, local prescribing rules that allow it and a country where the drug is sold. A TRICARE host-nation network provider, a military hospital or clinic, or an Embassy Health Unit provider who can prescribe locally can evaluate you.⁴¹

Military pharmacies, and network pharmacies in U.S. territories, use Express Scripts' form. Other retail pharmacies abroad use International SOS's, where you pay the full price up front and file a claim. Approval lasts 12 months, and then you requalify.⁴¹

Type 2 diabetes. Ozempic, Mounjaro, Trulicity and Victoza stay covered for type 2 diabetes when you meet TRICARE's criteria, on every plan, TRICARE For Life included. Express Scripts' form for Ozempic and Mounjaro asks for a type 2 diabetes diagnosis and a metformin trial, unless you can't take metformin. Trulicity has a lower copay.^{10, 40, 43}

What you pay in 2026. Copays depend on where you fill and the drug's tier on TRICARE's formulary (drug list):²⁵

• Military pharmacy: $0.
• TRICARE Home Delivery, up to a 90-day supply: $44 for a brand-name formulary drug, $85 for a non-formulary drug.
• Network pharmacy, up to a 30-day supply: $48 for a brand-name formulary drug, $85 for a non-formulary drug.
• Survivors of active-duty members, and medically retired members and their families, kept their earlier copays.

Search the TRICARE Formulary Search Tool for your drug's tier, form and where to fill it. Check Foundayo's status there too: we found it in no TRICARE or Express Scripts document. For other help with your pharmacy benefit, Express Scripts' TRICARE line is 877-363-1303.^{25, 44}

What the September 2026 prior authorization form asks

Express Scripts' current TRICARE form for Wegovy injection and tablets and for Zepbound is dated September 9, 2026. Take this list to your appointment:²⁴

• Who prescribes: in the U.S., a military provider or a TRICARE network provider who has billed TRICARE for the visit where they assessed you and made a plan. Otherwise the request stops.
• Your plan: Prime or Select, or a premium plan that carries their benefits (see the table). Other plans stop.^{11, 24}
• Adults, BMI: 30 or more qualifies. 27 to 29 also needs a weight-related condition, such as diabetes or prediabetes, sleep apnea, osteoarthritis, metabolic syndrome, high cholesterol, high blood pressure, MASH, or cardiovascular disease with a past stroke, heart attack or peripheral artery disease. Below 27 stops.
• Adults, lifestyle first: your provider confirms in your record at least 6 months of diet and behavior changes without the hoped-for loss, and that you'll keep at it.
• Adults, an older drug first: 3 months of generic phentermine, benzphetamine, diethylpropion or phendimetrazine with less than a 5% loss. You also qualify if you can't take them (for example with heart rhythm problems, coronary artery disease, heart failure, stroke, or blood pressure above goal on two or more medicines). So does a reaction to one that wouldn't be expected with the GLP-1, or a 5% loss on one while your BMI and belly fat stay high.
• Ages 12 to 17: Wegovy injection only, with a BMI at or above the 95th percentile for age and sex and 6 months of lifestyle changes. The older-drug step doesn't apply, and renewal needs a 4% loss. Under 12 stops.
• Sleep apnea route (Zepbound only): adults with moderate to severe obstructive sleep apnea (an apnea-hypopnea index of 15 or more events an hour), a BMI of at least 30 and 6 months of lifestyle changes. Wegovy requests stop here.
• Automatic stops: pregnancy, taking another GLP-1 drug, or a personal or family history of MTC or MEN 2.
• What it won't approve: anything but weight management and, for Zepbound, sleep apnea. Other diagnoses stop, including Wegovy's heart-risk and MASH uses.
• How long: 12 months. Adults renew with a loss of at least 5% of starting weight once the dose is fully increased, or, on the sleep apnea route, a better apnea-hypopnea index. A restart after a break goes back to the first step.

About the older drugs. All four are stimulant-type appetite suppressants. Each label approves the drug only as a short-term add-on (a few weeks) to a weight-reduction program, so ask your prescriber how TRICARE's 3-month trial fits that.^{27, 28, 29, 30}

All four labels rule them out with certain heart and blood vessel problems, including high blood pressure (uncontrolled on phentermine's label, severe on diethylpropion's, moderate or severe on the other two). They also rule them out with hyperthyroidism (an overactive thyroid), glaucoma, an agitated state, a history of drug abuse, an allergy or unusual reaction to stimulant-type drugs, or current use of an MAOI, a type of antidepressant. Each also warns against use within 14 days after an MAOI. The labels also warn against combining the drug with other weight-loss products, including prescription, over-the-counter and herbal ones.^{27, 28, 29, 30}

Each warns that the drug may impair driving or running machinery and can be misused. Each also warns of pulmonary hypertension, a rare but often fatal lung disease, and of heart valve disease seen with some appetite suppressants. Three add that in one study, use for more than 3 months went with a 23-fold higher risk of pulmonary hypertension.^{27, 28, 29, 30}

Phentermine's label also rules out pregnancy and breastfeeding. Benzphetamine's rules out pregnancy and advises against breastfeeding. Phendimetrazine's allows either only if a doctor judges the benefit worth the risk, and diethylpropion's allows use in pregnancy only if clearly needed and urges caution while breastfeeding. Tell your prescriber if either applies.^{27, 28, 29, 30}

If Express Scripts denies the request. Express Scripts checks requests against criteria set by DoD's Pharmacy and Therapeutics Committee, and TRICARE says approval takes about 10 days. After a denial, Express Scripts tells you and your provider how to appeal and what can help a further review. Other options are a different covered drug or paying yourself.^{42, 45} Follow the steps and deadline in that notice, and track any appeal in your Express Scripts account.⁴⁵

TRICARE's pharmacy appeals page says an appeal must be in writing and signed, say specifically why you disagree and include a copy of the decision. It must be postmarked, or received by Express Scripts, within 90 calendar days from the date of the decision. Mail it to Express Scripts, Inc., P.O. Box 60903, Phoenix, AZ 85082-0903.⁴⁶

TRICARE For Life

TRICARE For Life (TFL) covers TRICARE-eligible people who have Medicare Part A and Part B. It hasn't covered weight-loss drugs since August 31, 2025, when approvals for that use stopped being valid.^{11, 40, 47}

TRICARE says the reason is legal. Federal law doesn't let TFL cover weight-loss medicines when weight loss is the only or main condition, at any age, and TFL's rules exclude medicines meant to control weight even if you have other conditions. So unlike Medicare Part D, TFL makes no exception for sleep apnea or heart risk. TRICARE told people affected by the change not to stop their medicine right away but to ask their provider.⁴⁰

Part D and the Bridge. You don't need Medicare Part D with TFL, but you can add a plan. TRICARE's 2023 explainer says you can join in your first enrollment period, in open enrollment (October 15 to December 7 each year) or in a special period that TRICARE coverage gives you, with no late penalty. Part D then pays first and TRICARE last, and most people pay a monthly premium for it.⁴⁷

That matters because Medicare's temporary GLP-1 Bridge covers certain weight-loss GLP-1s for a $50 copay through 2027, for some people with Part D (see how the Bridge works and who qualifies).^{10, 48}

Paying cash. Anyone TRICARE, the VA or CHAMPVA won't pay for, including TFL members, can't use the drugmakers' copay cards, which exclude TRICARE, VA and DoD enrollees. They can use the drugmakers' self-pay offers by paying cash outside the plan and not seeking repayment.^{49, 50}

As of October 3, 2026, LillyDirect charges $449 per 28-day supply of Zepbound vials or KwikPens at 7.5 mg and up, needles extra, when each refill comes within 45 days of the last. For KwikPens, that price runs through a Lilly cash-buyer card that allows up to 11 fills a calendar year and ends December 31, 2026.^{50, 51} NovoCare sells Wegovy pens up to 2.4 mg for $349 a month (a box of four pens) and says its pricing will be updated after December 31, 2026.^{49, 52} See our GLP-1 price page and which offer each kind of buyer can use.

VA care for veterans

For weight management, the VA can prescribe Wegovy, Zepbound or Foundayo if you meet its criteria. None is on the VA National Formulary, VA's standard drug list, so each needs a non-formulary request. The usual path:^{12, 15, 38}

1. Ask your VA primary care team whether you meet the criteria below.
2. Have at least one documented visit with a lifestyle program in the past year; VA's MOVE program is one. You don't have to finish it first, because VA's June 2026 recommendations let these medicines start any time during the program.^{12, 53, 54}
3. Your VA provider sends the request. Each medical center must answer a non-urgent request within 96 hours once it has all the information it needs.³⁸

The criteria. VA's Wegovy, Zepbound and Foundayo criteria share two requirements: documented time in a program covering diet, activity and behavior, and a BMI of 27 or more with at least one weight-related condition. Examples include type 2 diabetes, prediabetes, high blood pressure, high cholesterol, metabolic syndrome, sleep apnea, osteoarthritis, fatty liver disease (MASLD) and a type of heart failure. Zepbound's and Foundayo's lists also include a past heart attack or stroke, or peripheral artery disease that causes symptoms, and Wegovy's notes its heart-risk use for the same people. VA's lists are "not limited to" these examples, and your facility decides exceptions case by case.^{12, 13, 14}

Who the criteria rule out. They exclude pregnancy, breastfeeding, a personal or family history of MTC or MEN 2, severe stomach or bowel motility problems including gastroparesis, and past pancreatitis unless its cause is known and no longer a risk. Type 1 diabetes is excluded unless a diabetes or weight-management specialist follows you, and serious diabetic eye disease unless the risks have been discussed and documented and an eye specialist follows it. Foundayo's criteria add severe liver impairment and some medicines that strongly speed up or block CYP3A4, such as rifampin or ritonavir.^{12, 13, 14}

How long the VA prescribes it. VA's June 2026 recommendations treat these as long-term medicines, because stopping often leads to weight regain, and refills don't specifically require proof that you're still in a lifestyle program. They also say your VA prescriber should stop one that hasn't produced about a 5% loss after 3 months on the highest dose you can tolerate, or whose loss isn't kept off. The exact threshold and timing vary by drug and follow its label (Saxenda's uses at least 4% after 16 weeks in adults).^{21, 53}

That decision belongs to your prescriber, so talk with your VA team before stopping; a different medicine may be tried if you keep up the lifestyle program.⁵³

What you pay. Veterans in priority group 1 pay no copay for any medicine; others may owe copays for medicines that treat conditions not connected to their service. On VA's rate page (last updated December 29, 2025), tier 3 (brand-name) medicines cost $11 for up to 30 days, $22 for 31 to 60 days or $33 for 61 to 90 days. Tier 2 costs $8, $16 or $24. Medication copays stop for the year once you've been charged $700.^{15, 16}

If the VA denies the request. Your VA provider can appeal, and the chair of your medical center's pharmacy and therapeutics committee decides. You can also raise it yourself: VA says to talk with your provider, then the provider's supervisor or chief of service, then your facility's patient advocate, who can help you file an appeal.^{38, 55}

VA policy counts "whether a particular drug should be prescribed" among the decisions you can appeal. The patient advocate helps you put it in writing, most appeals are decided within 45 business days, and a facility decision can go to a second review by your regional VA network.⁵⁶ If the answer is still no, see paying cash or, with Medicare Part D, Medicare's GLP-1 Bridge.

CHAMPVA for spouses, children and survivors

CHAMPVA is VA's health program for some spouses, dependent children and survivors of veterans who meet service-connected disability rules. People eligible for TRICARE can't use it.⁵⁷ It doesn't cover GLP-1 medicines for weight loss, even though some are FDA-approved for it.³⁵

CHAMPVA covers them only for these FDA-approved uses:^{6, 35}

• Mounjaro, Ozempic, Trulicity or Victoza for type 2 diabetes.
• Zepbound for moderate to severe sleep apnea.
• Wegovy for MASH within its approved use (moderate to advanced scarring, not cirrhosis), or to lower the risk of heart attack, stroke and cardiovascular death in people who have already had one of these events.

If you have another prescription plan, such as Medicare Part D or an employer plan, CHAMPVA says that plan pays first, so check its coverage. With Part D, also see Medicare's GLP-1 Bridge. To pay yourself, see paying cash.³⁵

Questions go to CHAMPVA at 800-733-8387 (TTY 711), weekdays from 8:00 a.m. to 7:30 p.m. ET.³⁵

Sources

1. GLP-1 Prescription Medications: Uses and Safety (posted June 3, 2026), Operation Supplement Safety (OPSS), Uniformed Services University, accessed October 3, 2026.
2. 10 U.S. Code § 10101: Reserve components named, U.S. Code, Legal Information Institute, Cornell Law School, accessed October 3, 2026.
3. Prokop RL, Stork BF, James LC. Should Military Aircrew Members be Allowed to Use Food and Drug Administration Approved Weight Loss Medications? A Review of the Literature and Recommendations. Military Medicine, November 2025, PubMed, National Library of Medicine, accessed October 3, 2026.
4. OZEMPIC (semaglutide) injection: prescribing information, Novo Nordisk, on DailyMed (National Library of Medicine), accessed October 3, 2026.
5. MOUNJARO (tirzepatide) injection: prescribing information, Eli Lilly and Company, on DailyMed (National Library of Medicine), accessed October 3, 2026.
6. WEGOVY (semaglutide) injection and tablets: prescribing information and Medication Guide, Novo Nordisk, on DailyMed (National Library of Medicine), accessed October 3, 2026.
7. ZEPBOUND (tirzepatide) injection: prescribing information and Medication Guide, Eli Lilly and Company, on DailyMed (National Library of Medicine), accessed October 3, 2026.
8. Department of Defense Office of Drug Demand Reduction Program (briefing to SAMHSA's Drug Testing Advisory Board, December 2018), U.S. Department of Defense, Office of Drug Demand Reduction, hosted by SAMHSA, accessed October 3, 2026.
9. Department of Defense Drug Demand Reduction Program (briefing to SAMHSA's Drug Testing Advisory Board, March 2023), U.S. Department of Defense, Office of Drug Demand Reduction, hosted by SAMHSA, accessed October 3, 2026.
10. Does TRICARE cover Wegovy, Ozempic, and Mounjaro? (last updated August 6, 2026), TRICARE, Defense Health Agency, accessed October 3, 2026.
11. TRICARE Coverage of Weight Loss Medications: What To Know (August 5, 2025), TRICARE Newsroom, Defense Health Agency, accessed October 3, 2026.
12. Semaglutide (WEGOVY) Subcutaneous Injection and Oral Tablet for Weight Management: Criteria for Use (April 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
13. Tirzepatide (ZEPBOUND) Subcutaneous Injection for Weight Management: Criteria for Use (April 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
14. Orforglipron (FOUNDAYO) Oral Tablets for Weight Management: Criteria for Use (May 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
15. VA National Formulary data file (VANF.json), VA Formulary Advisor (data refreshed September 29, 2026), Pharmacy Benefits Management Services, U.S. Department of Veterans Affairs, accessed October 3, 2026.
16. Current VA health care copay rates (last updated December 29, 2025), U.S. Department of Veterans Affairs, accessed October 3, 2026.
17. About Operation Supplement Safety (OPSS), Operation Supplement Safety (OPSS), Uniformed Services University, accessed October 3, 2026.
18. VA/DoD Clinical Practice Guideline for the Management of Adult Overweight and Obesity (September 2025), U.S. Department of Veterans Affairs and U.S. Department of Defense, accessed October 3, 2026.
19. Army Regulation 40-3: Medical, Dental, and Veterinary Care (April 23, 2013), Headquarters, Department of the Army, accessed October 3, 2026.
20. FOUNDAYO (orforglipron) tablets: prescribing information, Eli Lilly and Company, on DailyMed (National Library of Medicine), accessed October 3, 2026.
21. SAXENDA (liraglutide) injection: prescribing information and Medication Guide, Novo Nordisk, on DailyMed (National Library of Medicine), accessed October 3, 2026.
22. VICTOZA (liraglutide) injection: prescribing information, Novo Nordisk, on DailyMed (National Library of Medicine), accessed October 3, 2026.
23. Deployment Prescription Program, Express Scripts, TRICARE Pharmacy Program, accessed October 3, 2026.
24. TRICARE Prior Authorization Request Form for semaglutide injection/tablets (Wegovy), tirzepatide injection (Zepbound Pen Injector) (September 9, 2026), Express Scripts, for the Department of Defense, accessed October 3, 2026.
25. Changes to your TRICARE prescription drug copayments in 2026 (published November 3, 2025), Express Scripts, TRICARE Pharmacy Program, accessed October 3, 2026.
26. Where can I fill my GLP-1 medications?, Express Scripts, TRICARE Pharmacy Program, accessed October 3, 2026.
27. LOMAIRA (phentermine hydrochloride) tablets: prescribing information, KVK-Tech, on DailyMed (National Library of Medicine), accessed October 3, 2026.
28. Benzphetamine hydrochloride tablets: prescribing information, KVK-Tech, on DailyMed (National Library of Medicine), accessed October 3, 2026.
29. Diethylpropion hydrochloride tablets: prescribing information, KVK-Tech, on DailyMed (National Library of Medicine), accessed October 3, 2026.
30. Phendimetrazine tartrate tablets: prescribing information, KVK-Tech, on DailyMed (National Library of Medicine), accessed October 3, 2026.
31. Phentermine: A Prescription Drug for Weight Loss (updated March 7, 2025), Operation Supplement Safety (OPSS), Uniformed Services University, accessed October 3, 2026.
32. TRULICITY (dulaglutide) injection: prescribing information, Eli Lilly and Company, on DailyMed (National Library of Medicine), accessed October 3, 2026.
33. Semaglutide (OZEMPIC) Injection for Type 2 Diabetes Mellitus: Criteria for Use (April 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
34. Tirzepatide (MOUNJARO) Injection for Type 2 Diabetes Mellitus: Criteria for Use (April 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
35. CHAMPVA care (last updated August 12, 2026), U.S. Department of Veterans Affairs, accessed October 3, 2026.
36. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss (content current as of October 1, 2026), U.S. Food and Drug Administration, accessed October 3, 2026.
37. Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A of the Federal Food, Drug, and Cosmetic Act: Guidance for Industry (January 2018), U.S. Food and Drug Administration, accessed October 3, 2026.
38. VHA Directive 1108.08: VHA Formulary Management Process (July 29, 2022), Veterans Health Administration, U.S. Department of Veterans Affairs, accessed October 3, 2026.
39. Medical Standards for Military Service: Appointment, Enlistment, or Induction (DoW Instruction 6130.03, Volume 1, May 6, 2018, incorporating Change 6, February 3, 2026), Office of the Under Secretary of War for Personnel and Readiness (U.S. Department of Defense), accessed October 3, 2026.
40. Q&A: TRICARE For Life Coverage of Weight Loss Medications (September 8, 2025), TRICARE Newsroom, Defense Health Agency, accessed October 3, 2026.
41. Q&A: Understanding TRICARE coverage of weight loss medications overseas (June 30, 2026), Defense Health Agency, TRICARE Communications, accessed October 3, 2026.
42. Getting Prior Authorizations for TRICARE Prescriptions: Your Questions Answered (May 20, 2025), TRICARE Newsroom, Defense Health Agency, accessed October 3, 2026.
43. TRICARE Prior Authorization Request Form for Ozempic, Mounjaro (dated November 9, 2022), Express Scripts, for the Department of Defense, accessed October 3, 2026.
44. Are Glucagon-Like Peptide 1 (GLP-1) and weight loss medications covered through the TRICARE pharmacy benefit?, Express Scripts, TRICARE Pharmacy Program, accessed October 3, 2026.
45. Prior Authorization and Medical Necessity Basics: What You Should Know (published May 13, 2026), Express Scripts, TRICARE Pharmacy Program, accessed October 3, 2026.
46. Pharmacy Appeals (last updated May 22, 2025), TRICARE, Defense Health Agency, accessed October 3, 2026.
47. Understanding Medicare Part D and TRICARE Pharmacy Coverage (July 27, 2023), TRICARE Newsroom, Defense Health Agency, accessed October 3, 2026.
48. Medicare GLP-1 Bridge, Centers for Medicare & Medicaid Services, accessed October 3, 2026.
49. Terms and conditions of use (Wegovy savings offer and self-pay offer), Novo Nordisk (NovoCare), accessed October 3, 2026.
50. Zepbound (tirzepatide): Full Terms and Conditions, Eli Lilly and Company (LillyDirect), accessed October 3, 2026.
51. Zepbound (tirzepatide) | LillyDirect, Eli Lilly and Company (LillyDirect), accessed October 3, 2026.
52. Savings Offer Program for Wegovy (semaglutide), Novo Nordisk (NovoCare), accessed October 3, 2026.
53. Weight Management Medications for Chronic Use: Clinical Recommendations for Treatment Selection (June 2026), VA Pharmacy Benefits Management Services and National Formulary Committee, accessed October 3, 2026.
54. MOVE Weight Management Program for Veterans (last updated August 6, 2026), VA National Center for Health Promotion and Disease Prevention, accessed October 3, 2026.
55. Patient Advocate (last updated May 9, 2022), Veterans Health Administration, U.S. Department of Veterans Affairs, accessed October 3, 2026.
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57. CHAMPVA benefits, U.S. Department of Veterans Affairs, accessed October 3, 2026.

How we made this page

This page answers questions from service members, applicants, veterans and military families, whose rules come from different agencies. An AI model drafted it from the 57 documents in the source list, read on October 3, 2026. The ones that carried the most weight were DoD's accession standards (DoD Instruction 6130.03, Volume 1), OPSS's GLP-1 and phentermine articles, the September 2025 VA/DoD obesity guideline, two DoD drug-testing briefings, Express Scripts' TRICARE forms and notices, TRICARE's FAQ and newsroom Q&As, VA's formulary data, Criteria for Use and directives, and twelve FDA labels on DailyMed.

What the page says about PlexusDx's own programs comes from PlexusDx's records and its published Terms of Service as of October 19, 2026, so it has no source number. Much of the rest comes from PDFs and data files that agencies revise, such as VA's formulary data and Express Scripts' forms, so the source list gives the date each document was read.

A script found each quotation in our evidence file in the document it is credited to, such as the TRICARE form, VA data file or FDA label. For sites that block scripts, such as Lilly's and TRICARE's newsroom, it used copies made the same day through a page-rendering service or, for one TRICARE Q&A and TRICARE's pharmacy appeals page, verbatim excerpts fetched that day.

Several rounds of AI review then compared each sourced statement with its source, and each statement about PlexusDx with PlexusDx's records and Terms, and AI editors revised the page after each round. Matching text to sources is not medical or legal judgment, and those checks do not supply it. None of the government agencies named here (the Defense Department, TRICARE and the VA), Express Scripts or the drugmakers reviewed or endorsed this page; their names appear only to identify them.

We did not review DoD's retention, deployment-limiting or aircrew standards for this page. The two older PlexusDx posts on these questions contributed nothing here; their text, figures and claims were all dropped.

PlexusDx sells compounded GLP-1 treatment, so we have a financial interest in this topic. Jay Hastings reviewed and approved this version on October 19, 2026. Dr. Asad K. Niazi, MD, MPH, reviewed the medical content on October 17, 2026. He is co-founder and CEO of Lone Star Virtual Health, the company that provides PlexusDx's prescribing clinicians, so he has a business relationship with PlexusDx. TRICARE, VA and DoD rules change, so confirm any rule with the agency before you act on it; our editorial policy applies to this page.