Does Express Scripts cover Wegovy and Zepbound?
What Express Scripts’ national drug lists say for 2026 and 2027, which Zepbound forms are excluded, and how to find your plan’s rules.
Written for the United States. A reference page: we update it when Express Scripts publishes a change.
Express Scripts’ 2026 National Preferred Formulary lists Wegovy pens, Wegovy tablets, Wegovy HD and single-dose Zepbound pens. Zepbound KwikPens and vials are excluded, in the October 1, 2026 version and on the 2027 list. Your plan decides whether weight-loss drugs are covered, and Express Scripts says its approval criteria are available on request.
Key takeaways
- Express Scripts’ 2026 National Preferred Formulary lists Wegovy pens, Wegovy tablets, Wegovy HD, single-dose Zepbound pens and Foundayo.1
- Express Scripts excludes Zepbound KwikPens and Zepbound vials in the October 1, 2026 version of its 2026 exclusion list, and again on its 2027 list.2,3
- Express Scripts says not every listed drug is covered by every plan; your benefit materials show which drugs and copays apply to you.1
- Express Scripts’ prescriber page says its prior authorization criteria are “available upon request”; we found no public copy for Wegovy or Zepbound.4
- In July 2025, Express Scripts said Wegovy and Zepbound would join a program that limits the monthly copay for GLP‑1 weight-loss medicines to “no more than $200” in participating plans.5
- Express Scripts manages drug lists for employers and health plans. Your plan decides what it covers. The lists below are Express Scripts’ national lists, not your plan’s final rules.
- This page describes published rules. It doesn’t tell you whether you qualify: your plan and your prescriber decide that.
- Wegovy and Zepbound need a prescription and carry real risks: see our side effects guide.
On this page
- What is Express Scripts, and does its list decide your coverage?
- Where do Wegovy and Zepbound sit on Express Scripts’ list?
- What has Express Scripts changed, and when?
- What approval rules has Express Scripts published?
- How do you find your own plan’s version?
- What can you do if your plan says no?
- Questions people ask
- How we researched this
- Sources
What is Express Scripts, and does its list decide your coverage?
Express Scripts is a pharmacy benefit manager: it says it “manages your prescription plan for your employer, plan sponsor, health plan or benefit fund.”2 It publishes national drug lists, but your plan decides which drugs it covers and your copays.1
A formulary is a list of the prescription drugs a plan covers. Express Scripts’ national list is the National Preferred Formulary; the public copy is a shortened list of the most commonly prescribed drugs.1 It “does not guarantee coverage,” and “not all the medications listed are covered by all prescription plans.”1
Express Scripts also publishes an exclusion list. Excluded drugs “are not covered” on the formulary, and each comes with named preferred alternatives.2
Where do Wegovy and Zepbound sit on Express Scripts’ list?
On the 2026 National Preferred Formulary, Wegovy pens, tablets and HD and the single-dose Zepbound pen are listed, while Zepbound KwikPens and vials are excluded.1,2
The weight-loss row of the exclusion list names six preferred alternatives: generic liraglutide, Foundayo, Wegovy HD, Wegovy pens, Wegovy tablets and Zepbound pens.2 The brand Saxenda is excluded because its generic, liraglutide, is covered.2
| Medicine | 2026 list (version of October 1, 2026) | 2027 exclusion list (dated August 1, 2026) |
|---|---|---|
| Wegovy pens, Wegovy tablets, Wegovy HD | Listed; preferred alternatives1,2 | Preferred alternatives3 |
| Zepbound single-dose pens | Listed; preferred alternative1,2 | Preferred alternative3 |
| Zepbound KwikPens and vials | Excluded2 | Excluded3 |
| Foundayo | Listed; preferred alternative1,2 | Preferred alternative3 |
| Saxenda (brand) | Excluded; generic liraglutide covered2 | Excluded3 |
| Ozempic, Ozempic tablets, Mounjaro, Rybelsus, Trulicity | Listed (diabetes medicines)1 | Not on the exclusion list3 |
What has Express Scripts changed, and when?
Express Scripts excluded Zepbound vials from January 1, 2026, and the October 2026 version of its list excludes Zepbound KwikPens as well.6,2
- Jul 10, 2025Express Scripts said Wegovy and Zepbound would join its Patient Assurance Program later in 2025, and the monthly copay for GLP‑1 weight-loss medicines would be limited to “no more than $200.” It ties the program’s caps to members of “participating health plans and employers.”5
- Jan 1, 2026A 2025 notice of changes for January 1, 2026 marks Zepbound vials as a new exclusion, alongside Saxenda. Wegovy and Zepbound pens were the preferred alternatives.6
- Oct 1, 2026The current version of the 2026 exclusion list excludes Zepbound KwikPens and vials. It names Foundayo, Wegovy HD and Wegovy tablets among the alternatives.2
- Jan 1, 2027The 2027 exclusion list, dated August 1, 2026, keeps the same weight-loss row.3
The exclusion lists don’t give a reason for excluding some Zepbound forms. They name the alternatives Express Scripts prefers instead.2
What approval rules has Express Scripts published?
Express Scripts says its prior authorization criteria are “available upon request”; we found no public copy for Wegovy or Zepbound.4
Prior authorization means your prescriber asks the plan to approve a drug before it pays. Express Scripts takes requests electronically, by phone or by fax.4 Its prescriber page also has a general request form for coverage decisions, such as a step-therapy exception.4
If there’s a clinical reason to stay on an excluded drug, your doctor can “request a coverage review” at esrx.com/PA.2
Because the criteria aren’t published, ask your plan for them in writing before your prescriber applies. Your plan’s own rules may differ from Express Scripts’ national list.1
If a request is denied, an employer plan must share the guideline it used.7
If your plan won’t pay, see a year at the makers’ self-pay prices, by dose step. No sign-up.
How do you find your own plan’s version?
Log on to express-scripts.com to check your drugs, and call the number on your prescription ID card for coverage questions.2
- 1Log on. Express Scripts points members to express-scripts.com/covered to compare medication prices.2
- 2Read your benefit materials. They list “the specific medications covered and the copays for your plan.”2
- 3Call the number on your prescription ID card with specific coverage questions.2
- 4Ask three things: is weight management covered, which forms are covered, and is your plan in the $200 cap.
- 5Your prescriber sends the request electronically, by phone or by fax.4
What can you do if your plan says no?
Ask for the reason in writing, check it against the plan’s criteria, and appeal: federal rules give you at least 180 days after the denial to file an internal appeal.8,7
If your coverage comes through a job, a federal rule says the denial must give you the guideline used. Or it must say one was used, and that you can have a free copy.7 You can also ask for free copies of the documents behind your claim.7
On the national list, your doctor can ask for a coverage review to stay on an excluded form, such as a KwikPen.2
If the plan still says no after its internal appeal, you can ask for an independent external review.8 Exceptions are explained in reading your drug list and asking for an exception. Appeals are in how GLP‑1 appeals work. If weight-loss drugs aren’t a benefit at all, see GLP‑1 costs without insurance.
Questions people ask
Does Express Scripts cover Ozempic or Mounjaro?
The 2026 National Preferred Formulary lists Mounjaro, Ozempic, Ozempic tablets, Rybelsus and Trulicity. Your plan’s own list and rules still apply.1
Does Express Scripts cover Zepbound vials or KwikPens?
Not on its national list. The 2026 and 2027 exclusion lists exclude both and name single-dose Zepbound pens, and Wegovy, as preferred alternatives.2,3
Does the $200 copay cap apply to everyone?
Not automatically. Express Scripts ties its Patient Assurance Program to members “covered by participating health plans and employers.” Ask your plan whether it takes part.5
Is Express Scripts my insurance?
Express Scripts runs the drug list. Your plan decides which listed drugs it covers and your copays.1
Does this apply to Medicare plans?
This page covers Express Scripts’ commercial lists, not Medicare drug plans. By law, Medicare can’t cover drugs used only for weight loss; the temporary Medicare GLP‑1 Bridge, from July 1, 2026, to December 31, 2027, is the exception. Part D plans can cover GLP‑1s for type 2 diabetes, heart risk or sleep apnea.9 See how Medicare covers GLP‑1s.
How we researched this
We read Express Scripts’ own documents: its 2026 drug list, the 2026 and 2027 exclusion lists, a 2025 change notice, its prescriber page and an announcement.1,2,3,6,4,5
We searched for Express Scripts’ prior authorization criteria for Wegovy and Zepbound and found no public copy; its prescriber page says they’re available on request. Appeal rights come from HealthCare.gov and the federal claims rule. All sources were checked on Oct 14, 2026.8,7
Before you move on
- Ask HR or the number on your card whether weight-loss drugs are covered at all.
- Ask which forms are covered: single-dose pens, vials or KwikPens.
- Ask for the prior authorization criteria for your plan, in writing.
- Collect proof of your starting BMI and any weight program you’ve done.
- If you’re denied, check the appeal deadline in the denial letter, and appeal in writing.
More on insurance
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Sources
- Express Scripts (Evernorth). 2026 Express Scripts National Preferred Formulary, version PRMT22157-26 (10/01/2026), effective January 1 through December 31, 2026. Checked Oct 14, 2026. Link
- Express Scripts (Evernorth). 2026 National Preferred Formulary Exclusions, version EXCL-NPF-26 (10/01/2026). Checked Oct 14, 2026. Link
- Express Scripts (Evernorth). 2027 National Preferred Formulary Exclusions, version NP Excl (08/01/2026). Checked Oct 14, 2026. Link
- Evernorth. Prior authorization resources, for prescribers (Express Scripts). Checked Oct 14, 2026. Link
- Evernorth. Express Scripts expands Patient Assurance Program to drive affordability and access to GLP-1s. July 10, 2025. Link
- Evernorth. 2026 National Preferred Formulary: exclusion list changes coming January 1, 2026 (file named “250806”, © 2025). Checked Oct 14, 2026. Link
- US Department of Labor. Claims procedure, 29 CFR 2560.503-1, paragraphs (g)(1)(v)(A), (h)(2)(iii) and (h)(3)(i) (federal rule for employer benefit plans), via Cornell Law School LII. Checked Oct 14, 2026. Link
- HealthCare.gov. Internal appeals. Checked Oct 14, 2026. Link
- KFF. What to know about the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. May 11, 2026. Link
Last checked Oct 14, 2026 · Next review due Jan 14, 2027 · Report an error
How this page was made. Written by the GLP Guidebook team from Express Scripts’ own published documents and the other sources above. It’s general information, not medical or insurance advice. Talk to your doctor, pharmacist or prescriber before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand, insurer, benefit manager or provider. How we write