Which GLP-1s does Kaiser Permanente cover? 3 checked
Kaiser Permanente publishes a policy on 3 GLP-1s we track. Of those, 2 are covered with prior approval and 1 depends on your plan. Each answer below names the conditions it covers and cites the document it came from.
Does Kaiser Permanente cover Wegovy and Zepbound?
On some plans, yes. Each Kaiser region sets its own formulary, and some plans add a weight-loss benefit gate on top.
On some plans, yes, and which region you are in decides it. Kaiser Permanente is a set of separately licensed regional health plans and each one sets its own formulary and its own coverage criteria. Wegovy sits at Tier 2 on both 2026 California commercial drug lists, at Tier 5 with prior authorization on the Georgia list, and became formulary in the Northwest on June 18, 2026. It does not appear on the Colorado, Hawaii or Kaiser Permanente Washington commercial formularies at all. Zepbound appears on the Georgia and Kaiser Permanente Washington lists and is non-formulary in the Northwest. On top of the regional split, the Northwest criteria say coverage applies only to members whose plan includes the weight-loss drug benefit.
Source: 2026 Kaiser Permanente Northwest FEHB plan brochure RI 73-004, Section 5(f) prescription drug benefits and the 2026 changes summary. Read August 15, 2026.
The full Kaiser Permanente policy on Wegovy and Zepbound has the BMI bar, the step-therapy rule and what happens at renewal.
Does Kaiser Permanente cover Mounjaro?
Yes, with prior approval. Kaiser pays for Mounjaro once your prescriber gets the plan to sign off.
Kaiser Permanente covers Mounjaro for type 2 diabetes, but only through prior authorization with extensive step therapy. Kaiser's published Northwest criteria require patients to be on or to have failed maximum-tolerated semaglutide (2 mg weekly for at least 3 months) plus metformin, a sulfonylurea, pioglitazone, and an SGLT2 inhibitor, with A1C still above 6.9%. Mounjaro is FDA-approved for type 2 diabetes only, so Kaiser will not cover it for weight loss. The weight-loss tirzepatide is Zepbound, which Kaiser covers only when the employer plan buys a weight-loss drug benefit.
Source: Kaiser Permanente Northwest Region, Criteria for Drug Coverage: tirzepatide (Mounjaro). Read August 27, 2026.
The full Kaiser Permanente policy on Mounjaro has the BMI bar, the step-therapy rule and what happens at renewal.
Does Kaiser Permanente cover Ozempic?
Yes, with prior approval. Kaiser pays for Ozempic once your prescriber gets the plan to sign off.
Kaiser Permanente covers Ozempic for type 2 diabetes, but only after prior authorization through its Criteria-Based Consultation Prescribing Program. Approval requires a documented type 2 diabetes diagnosis and step therapy, usually a trial of metformin plus other diabetes drugs, with A1C still above target. Kaiser does not cover Ozempic for weight loss under the standard pharmacy benefit. Wegovy is the same semaglutide at a higher dose and is the version FDA-approved for weight loss. The criteria here are Kaiser Permanente Northwest's. Criteria and formulary status are set by region, so details can differ across Kaiser's California, Colorado, Mid-Atlantic, Georgia, Hawaii, and Washington plans.
Source: Injectable semaglutide (Ozempic): Criteria for Drug Coverage, Kaiser Permanente Northwest Region. Read August 27, 2026.
The full Kaiser Permanente policy on Ozempic has the BMI bar, the step-therapy rule and what happens at renewal.
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This is reference information, not medical or legal advice, and not a guarantee of coverage. GLP-1 coverage policies change often. Always confirm the current policy with your insurer using the number on your card before you rely on this page. If your experience differs from what is shown here, email hello@glpchart.com with the details and we will re-verify.