Military Retirees Fear Health Setbacks as Tricare Cuts Weight-Loss Medication Access

Beginning August 31, Tricare for Life will discontinue coverage for weight-loss medications for military retirees eligible for Medicare. This change has ignited significant backlash from patients and advocates, who argue that it may jeopardize health advancements and pave the way for additional reductions.

This month, the Defense Health Agency announced that medications including Wegovy, Zepbound, Saxenda, Qsymia, Phentermine, and Contrave will no longer be covered for Tricare for Life beneficiaries who are pursuing obesity treatment. The initiative includes military retirees eligible for Medicare along with their families.

The decision follows a significant increase in the utilization of GLP-1 medications such as Wegovy and Zepbound nationwide. Authorities indicated that the adjustment was essential to address what they characterized as unapproved reporting.

“Tricare has been offering coverage for weight loss medications to beneficiaries who did not qualify under federal law,” stated DHA spokesperson Brenda Campbell. “This implementation addresses that unauthorized coverage.”

Tricare will maintain coverage for the same medications for younger beneficiaries who are enrolled in Tricare Prime, Tricare Select, or premium-based plans, such as Tricare Young Adult and Tricare Retired Reserve. Patients are required to adhere to stringent clinical guidelines and obtain necessary prior approvals.

For retirees, the expenses associated with ongoing treatment could be overwhelming. A recipient shared with Military Times that her monthly cost for Wegovy amounts to $1,300. “That will consume a significant portion of our retirement funds,” she remarked. She attributed the medication to enhancements in health issues associated with obesity, such as pre-diabetes and sleep apnea.

The Military Officers Association of America, representing officers and their families, has called on the Defense Health Agency to stop the proposed change, cautioning that it could jeopardize significant health advancements for patients.

“Pausing this policy change would allow for a thorough evaluation of the legislative and regulatory background surrounding Tricare policy on weight-loss medications and identify the best course of action to prevent adverse effects,” stated MOAA health affairs director Karen Ruedisueli in a recent statement.

Certain advocates are raising concerns that this ruling may establish a troubling standard for the future. “Members who aren’t directly impacted have an additional worry: that this change sets a concerning precedent and may pave the way for more specific reductions to Tricare for Life,” Ruedisueli stated.

Tricare officials emphasized that coverage for diabetes treatment will continue without interruption. Patients with type 2 diabetes will still have access to medications such as Ozempic, Mounjaro, Victoza, and Trulicity when deemed medically necessary.

For numerous retirees, the Aug. 31 deadline is approaching rapidly. “Wegovy has been a game changer for my medical conditions,” one patient said. “They’ve simply severed it now.”