# FEHB GLP-1 Coverage 2027: The New Therapy Rule Source: https://www.dietglp.com/blog/fehb-glp-1-coverage/ Published: 2026-10-24 Keywords: fehb glp-1 coverage, fehb glp-1 coverage 2026, fehb glp-1 coverage 2027, fehb 2027 glp 1, fehb glp-1, does fehb cover glp 1, which fehb plans cover glp-1, fehb plans that cover glp 1, best fehb plan for glp 1 coverage, fehb wegovy, fehb wegovy coverage 2026, which fehb plan covers wegovy, fehb bcbs glp 1 coverage, kaiser fehb glp 1 **TL;DR:** Yes, FEHB plans still cover GLP-1 weight loss drugs in 2027, but with a new catch. OPM now requires every FEHB and PSHB plan to cover a drug like Wegovy or Zepbound for weight loss only if you take part in a documented intensive behavioral therapy (IBT) program before you start and while you stay on it. Open Season runs November 9 to December 14, 2026, so read each plan's 2027 brochure before you pick. App-only programs do not count as IBT, but [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) can help you track the protein and workouts that your program asks for. Does FEHB still cover GLP-1 drugs like Wegovy and Zepbound in 2027? **Yes, but you will have to do more to get them.** Starting with Plan Year 2027, the Office of Personnel Management (OPM) requires every FEHB and PSHB plan to cover weight loss medicine only when you take part in a documented intensive behavioral therapy (IBT) program. You join it before you start the drug, and you stay in it while you take the drug. Just saying you have tried to lose weight before is no longer enough. This matters right now. Federal Benefits Open Season runs **November 9 to December 14, 2026**, and plan brochures come out in early November. This week's Federal News Network rundown of 2027 FEHB changes put the rule in front of a lot of federal workers. Here is what OPM actually wrote, and what to check before you pick a plan. ## FEHB GLP-1 coverage 2027 at a glance | Question | 2027 answer | Source | |---|---|---| | Do plans still have to cover a GLP-1 for weight loss? | Yes, at least one, plus at least two oral anti-obesity drugs | OPM Carrier Letter 2026-07 | | What is new? | Documented IBT participation before and during treatment | OPM Carrier Letter 2026-07 | | Can a doctor's note about past diets replace IBT? | No, attestations alone should not bypass it | OPM Carrier Letter 2026-07 | | Do app-only or AI-only programs count? | No, virtual programs need human coaching | OPM Carrier Letter 2026-07 | | IBT sessions plans must cover | 12 to 22 per year, depending on progress | OPM Open Season highlights | | Qualifying program length | 26 or more contact hours over 3 to 12 months | OPM Open Season highlights | | Open Season | November 9 to December 14, 2026 | OPM Open Season highlights | | Average enrollee premium change | Up 10.9% for FEHB | OPM Open Season highlights | ## What is the new FEHB GLP-1 rule? Every spring OPM sends carriers a "Call Letter" that tells them what to put in next year's plans. The 2027 one is Carrier Letter 2026-07, dated March 31, 2026. Its obesity section keeps the old floor: one GLP-1 for weight loss and two oral options. Then it adds a new set of rules for Plan Year 2027. In plain English, the letter says: - **You must be in a real program first.** Plans must require participation in an obesity program built on intensive behavioral therapy, following guidelines from groups like the US Preventive Services Task Force (USPSTF), the Obesity Medicine Association or the Endocrine Society. - **It has to be documented.** The program can be in person or virtual, but the provider must certify that it meets that standard. - **You keep going while on the drug.** If a GLP-1 is prescribed, your plan expects continued participation and documentation. - **Prior authorization checks it.** OPM wrote that prior authorization must make sure you "demonstrated and will continue participation" in lifestyle changes of IBT rigor. - **The drug must be used as labeled.** Coverage has to match FDA labeling and clinical guidelines. OPM points out that FDA labels already pair these drugs with diet and physical activity. OPM also says plans should step up the therapy, not just the drug, when someone needs more help. ## What counts as intensive behavioral therapy? IBT is not a pamphlet or a one-time talk. OPM lists three parts: 1. Obesity screening using your BMI or waist-to-hip ratio. 2. A dietary assessment. 3. Repeated, high-intensity counseling on diet and exercise. Plans must cover individual IBT visits (billing code G0447) and group visits (G0473). OPM's summary says plans should cover 12 to 22 sessions a year depending on progress, and a qualifying program gives you 26 or more contact hours over 3 to 12 months. Doctors, nurse practitioners, physician assistants, exercise physiologists, lifestyle coaches and registered dietitians can lead the sessions, in person or by video. If you also qualify for medical nutrition therapy with a dietitian, your plan has to coordinate the two. One line is easy to miss: **smartphone apps or AI-only programs are not eligible.** A virtual program can count, but only if it includes human coaching and every IBT element. ## Which FEHB plans cover GLP-1 in 2027? All of them must cover at least one. That does not mean all of them cover the one you want, or at the same price. Each carrier picks its drugs, sets the tier and writes its own prior authorization form. OPM does not publish one master list. Because of that, the same Wegovy prescription can cost very different amounts on two different FEHB plans. What OPM does publish: - **Early November 2026:** full 2027 FEHB and PSHB brochures on OPM.gov and in the Plan Comparison Tool. - **November 9:** Open Season starts. - **December 14:** Open Season ends. Nine FEHB plans will not be offered in 2027. If yours is one of them, you must pick a new plan or you will be moved into a default plan. ## What to check in each plan brochure When the 2027 brochures go live, look for these five things: 1. **The formulary.** Is Wegovy (shot or pill), Zepbound or Foundayo listed for weight loss? What tier? 2. **The obesity section.** How does the plan describe its IBT program? Is it run by the plan, a vendor or your own doctor? 3. **Prior authorization.** How many weeks of program participation do you need before the drug is approved? 4. **Cost sharing.** Copay or coinsurance, and whether there is a cap. 5. **Current users.** If you already take a GLP-1, ask the plan in writing how the new rule applies to you on January 1. If your claim is denied later, you have appeal rights. Our [Zepbound appeal letter guide](/blog/zepbound-appeal-letter/) walks through the steps, and they work the same way for other GLP-1 drugs. ## Where Sharpy fits (and where it does not) Let us be clear: Sharpy is an app, so by OPM's rules it does not count as your IBT program. You still need the human-led program your plan approves. What Sharpy can do is help you do the homework those programs give you. Most IBT plans ask you to eat enough protein, move regularly and track progress. [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) turns that into one daily protein target, one 20-minute workout and one Shape Score, so you have something real to bring to each session. That also matters for your body. GLP-1 weight loss can include muscle, and our guide to [strength numbers on GLP-1](/blog/glp1-and-strength-numbers/) explains how to tell if you are keeping it. ## What if my FEHB plan will not cover my GLP-1? You have a few paths: - **Switch plans during Open Season** to one whose brochure covers your drug at a better tier. - **Pay cash** through the makers' programs. Our [LillyDirect Zepbound](/blog/lillydirect-zepbound/) and [TrumpRx GLP-1](/blog/trumprx-glp-1/) guides list current self-pay prices. - **Use FSAFEDS** for out-of-pocket drug costs. You must re-enroll every year during Open Season, because it does not carry over on its own. - **Talk to your prescriber** about which covered drug fits your health, rather than switching or stopping on your own. Many private employers are also tightening GLP-1 rules for 2027. Our guide on [insurance dropping GLP-1 coverage](/blog/insurance-dropping-glp-1-coverage/) covers that bigger picture. ## Does this apply to Ozempic or Mounjaro for diabetes? OPM's 2027 rule is about anti-obesity medications used for weight management. Neither the Call Letter nor the Open Season summary says it applies to GLP-1 drugs prescribed for type 2 diabetes. Plans write their own criteria, though, so confirm with your carrier. ## Your next step Before December 14, find out which IBT program each plan you are considering uses, and how long you must be in it before the drug is approved. Then start building habits now so you are ready. [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) can help with the daily part: hit your protein, do your 20 minutes and watch your Shape Score move. ## Sources - OPM, FEHB Program Carrier Letter 2026-07 (2027 Call Letter), Mar 31, 2026: https://www.opm.gov/healthcare-insurance/carriers/fehb/2026/2026-07.pdf - OPM, 2026 Federal Benefits Open Season Highlights for Plan Year 2027: https://www.opm.gov/healthcare-insurance/open-season/agency-benefits-officers/housing-for-os-materials/2026-federal-benefits-open-season-highlights-for-plan-year-2027.pdf - Checkbook, OPM policy goals for Plan Year 2027: https://help.checkbook.org/article/482-opm-announces-policy-goals-and-initiatives-for-plan-year-2027 - Federal News Network, OPM 2027 Call Letter coverage, Apr 2026: https://federalnewsnetwork.com/benefits/2026/04/opm-calls-on-federal-insurance-carriers-to-promote-well-care-cut-costs/ ## Frequently asked questions **Q: Does FEHB cover GLP-1 for weight loss in 2027?** A: Yes. OPM still requires every FEHB plan to cover at least one GLP-1 anti-obesity medication and at least two oral anti-obesity medications. What changes in 2027 is how you qualify: plans must require documented participation in an intensive behavioral therapy (IBT) program before and during treatment. **Q: What is the new FEHB GLP-1 rule for 2027?** A: OPM's Call Letter (Carrier Letter 2026-07, dated March 31, 2026) says anti-obesity medications must only be covered when used together with intensive behavioral therapy. Prior authorization must show you have taken part in a lifestyle program of that rigor before starting and will keep taking part while on the drug. **Q: Can I just say I tried diet and exercise before?** A: Not anymore. OPM wrote that attestation statements alone, from members or providers, about prior weight loss attempts should not bypass the new requirements. Your plan will want documented participation in a qualifying program. **Q: Does a weight loss app count as intensive behavioral therapy for FEHB?** A: No. OPM says smartphone-app-only or AI-only vendors are not eligible under this process. Virtual programs can count, but they must include human coaching and cover all the IBT elements, such as a dietary assessment and regular counseling sessions. **Q: Which FEHB plans cover Wegovy or Zepbound?** A: Every plan must cover at least one GLP-1 for weight loss, but plans choose which one and set their own tiers, copays and prior authorization forms. Full 2027 brochures go up on OPM.gov in early November 2026. Check the drug formulary and the obesity section of each brochure before Open Season ends on December 14. **Q: When does the new FEHB GLP-1 rule start?** A: It applies to Plan Year 2027. For most FEHB enrollees, Open Season changes take effect January 10, 2027 (January 1 for annuitants and PSHB enrollees). Ask your plan how it will handle members who are already on a GLP-1 when the year starts. **Q: Does the new rule apply to diabetes drugs like Ozempic or Mounjaro?** A: The 2027 rule is written for anti-obesity medications used for weight management. OPM's documents do not say it applies to GLP-1 drugs prescribed for type 2 diabetes. Each plan writes its own prior authorization criteria, so confirm with your plan.