(And what you can do about it)

At Dr. Shannon Wellness & Weight Loss, we know that navigating insurance coverage can be frustrating — especially when policies change unexpectedly. Many of our military families and retirees rely on TRICARE for their healthcare needs, and recent updates have affected coverage for weight-loss medications.

Here’s what you need to know about why TRICARE is no longer helping with certain weight-loss prescriptions, and how we can help you move forward confidently in your wellness journey.

🩺 What Changed?

As of August 31, 2025, TRICARE introduced new regulatory rules that limit coverage for weight-loss medications.

Here’s the breakdown:

• TRICARE will continue to cover medications like Ozempic, Mounjaro, or Victoza — but only when prescribed for Type 2 Diabetes, not for weight management.

• For drugs prescribed primarily for weight loss (such as Wegovy or Zepbound), coverage has been reduced or eliminated for particular TRICARE beneficiaries.

• TRICARE For Life (TFL) members — typically military retirees age 65 and older — are no longer eligible for these medications, even if they had prior authorization.

• Other TRICARE plans (Prime, Select, Reserve Select) may still cover weight-loss medications, but only under strict clinical criteria and with prior authorization approval.

In short, if you were using a TRICARE weight loss covered medication and fall under the TFL category, you’ll likely need to pay out of pocket after August 31, 2025.

💡 Why Did This Change Happen?

There are a few key reasons TRICARE made this decision:

1. Federal and Regulatory Limits

TRICARE’s coverage is guided by federal regulations, which traditionally exclude medications used primarily for weight reduction unless specific medical necessity criteria are met.

2. Rising Costs and High Demand

Weight-loss medications — especially newer GLP-1 drugs — have become extremely popular and expensive. To manage costs, TRICARE is narrowing eligibility.

3. Clinical Prioritization

TRICARE emphasizes lifestyle-based weight management as the foundation of care. Medications are considered secondary tools, used only when patients meet specific health criteria.

4. Plan Differences

TRICARE For Life beneficiaries (retirees 65+) are treated differently from Prime and Select enrollees. These plan distinctions are part of the updated policy.

⚖️ What This Means for You

If you’re a TRICARE member, here’s how these changes may affect you:

✅ Check your TRICARE plan type
Coverage depends on whether you’re enrolled in Prime, Select, or TRICARE For Life.

🚫 If you have TRICARE For Life
Weight-loss medications like Wegovy and Zepbound are no longer covered when prescribed for obesity alone.

📋 If you have Prime or Select
Coverage may still apply if you meet strict BMI and medical criteria — and your provider obtains prior authorization.

💰 Expect possible out-of-pocket costs
These medications can be costly, so planning is important.

🧠 Focus on comprehensive care
Medication is just one piece of your wellness plan — lifestyle, nutrition, and behavioral changes remain the foundation of effective long-term weight management.

💪 How Dr. Shannon Wellness & Weight Loss Can Help

Even with these coverage changes, we’re committed to helping you stay on track.

Here’s how we can support you:

• Prior Authorization Assistance: If coverage is possible, we’ll help submit documentation for approval.

• Lifestyle Coaching: We’ll help you strengthen your nutrition, exercise, and behavioral strategies to support natural weight loss.

• Medication Alternatives: We can explore safe, effective, and affordable treatment options tailored to your specific goals.

• Ongoing Support: Whether you’re adjusting medication or re-focusing on lifestyle care, we’ll be with you every step of the way.

❤️ The Bottom Line

TRICARE’s updated policy has created confusion and frustration for many beneficiaries — but you’re not alone.

At Dr. Shannon Wellness & Weight Loss, we’ll help you understand what’s changing, review your coverage, and make sure you have a personalized plan that keeps you moving toward your goals.

📞 Ready to Talk About Your Options?

If you’re unsure how these TRICARE changes affect your medication or treatment plan, schedule a consultation today.

👉 Call (228) 357-5720 or request an appointment online at drshannonwellness.com.
Let’s create a plan that supports your wellness — with or without medication coverage.

📚 Sources & References

1. TRICARE Official Coverage Page — Tricare Weight Loss Products
   🔗 https://www.tricare.mil/CoveredServices/IsItCovered/WeightLossProducts
   Explains which weight-loss medications are covered, under what circumstances, and details about prior authorization requirements.

2. TRICARE Newsroom — Coverage of Weight-Loss Medications: What to Know
   🔗 https://newsroom.tricare.mil/News/TRICARE-News/Article/4266447/tricare-coverage-of-weight-loss-medications-what-to-know
   Official announcement (August 2025) describing updated coverage policies effective August 31, 2025.

3. MOAA (Military Officers Association of America) — “Weight-Loss Drug Coverage Ends for TRICARE for Life Beneficiaries: What’s Next?”
   🔗 https://www.moaa.org/content/publications-and-media/news-articles/2025-news-articles/advocacy/weight-loss-drug-coverage-ends-for-tricare-for-life-beneficiaries-whats-next
   Summarizes how the policy affects TRICARE For Life members and offers updates on advocacy efforts.

4. MOAA — FAQ: TRICARE For Life and Weight-Loss Drugs
   🔗 https://www.moaa.org/content/publications-and-media/news-articles/2025-news-articles/health-care-and-earned-benefits/moaa-faq-tricare-for-life-and-weight-loss-drugs
   A clear FAQ explaining which plans are impacted and why.

5. Vance Air Force Base TRICARE News — “TRICARE Coverage of Weight-Loss Medications: What to Know”
   🔗 https://vance.tricare.mil/News-Gallery/Articles/Article/4266447/tricare-coverage-of-weight-loss-medications-what-to-know
   Local base update reflecting the same national TRICARE policy.

6. Defense Health Agency (Health.mil) — Formulary Management for Weight-Loss Agents (Fact Sheet)
   🔗 https://www.health.mil/Reference-Center/Fact-Sheets/2018/02/26/Formulary-Management-for-Weight-Loss-Agents
   Outlines the Defense Health Agency’s criteria and clinical considerations for prescribing weight-loss drugs.

7. Congressional Record – Discussion on TRICARE Coverage of Obesity Treatments
   🔗 https://www.congress.gov/113/chrg/CHRG-113shrg49104596/CHRG-113shrg49104596.pdf
   Provides background on the legislative framework that guides TRICARE’s coverage limitations for weight-loss medications.

8. Veteran News Network — “Military Health System Limits GLP-1 Drug Access for TRICARE Life Beneficiaries”
   🔗 https://www.veterannews.org/veteran-news/military-health-system-limits-glp-1-drug-access-for-tricare-life-beneficiaries
   Covers the financial and utilization factors contributing to the new restrictions.