Attention GLP-1 Users: Prior Authorization Required Beginning October 1, 2026

Starting October 1, 2026, the Fund will require prior authorization for GLP-1 medications used to treat type 2 diabetes and weight loss, including Ozempic, Wegovy, and Mounjaro.

This change helps ensure these high-cost medications are used safely, appropriately, and when medically necessary, while helping protect the Fund as GLP-1 medication costs continue to increase. In 2025 alone, the Fund paid more than $5 million for these medications.

What you need to know:

• For type 2 diabetes: If you currently take a GLP-1 medication, the Fund’s pharmacy benefit manager, CVS Caremark, will review your existing medical and prescription information to determine whether additional documentation is needed for prior authorization.
• For weight loss or weight maintenance: Prior authorization will be required and will follow FDA guidelines. In most cases, approval requires a BMI of 30 or higher, or a BMI of 27 or higher with related health conditions, such as high blood pressure, high cholesterol, or diabetes. Prior authorization must be renewed annually.

Members currently taking these medications will receive additional information from CVS Caremark before October 1, 2026.