Express Scripts (Evernorth) GLP-1 prior authorization in 2026.
Roughly 75 million US covered lives in 2026. Used by Cigna (Express Scripts is owned by Cigna's parent Evernorth) and others.
Plans administered by Express Scripts (Evernorth)
- Cigna (Express Scripts is owned by Cigna's parent Evernorth)
- Tricare
- Anthem affiliates in select states
- Many large-employer self-insured plans
The Express Scripts (Evernorth) step-therapy quirk you should know about
Express Scripts maintains the SaveOnSP and SafeGuard Rx programs that historically excluded GLP-1 manufacturer coupons from copay accumulators on some plans. This affects out-of-pocket math, not approval; verify with your specific plan whether you are in a SaveOnSP carve-in.
Expert tip
Tricare beneficiaries: Express Scripts is the Tricare pharmacy benefit administrator. The Tricare GLP-1 criteria are stricter than Cigna commercial criteria even though both run through Express Scripts. Use the Tricare-specific template, not the Cigna one.
The right plan-by-condition templates for Express Scripts (Evernorth)
Pick the template that matches your specific health plan and your qualifying indication. The plan and condition determine the PA criteria; the PBM determines how the letter is reviewed and submitted.
Other PBMs
