Does FEP Blue cover Ozempic?

Yes. FEP Blue covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

How long does a Ozempic approval last with FEP Blue?

Type 2 Diabetes — Applies to Federal Employee Program plans. Initial approval: 12 months. Renewal: every 12 months.

What does FEP Blue require to renew Ozempic?

Type 2 Diabetes — Applies to Federal Employee Program plans. Improvement in A1C. Glycemic control has improved or stabilized while on therapy. No dual therapy with other GLP-1 receptor agonists. T2DM diagnosis is re-verified at continuation.

How current is this information?

The oldest review date among the policies on this page is June 5, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

FEP Blue coverage for Ozempic (Type 2 Diabetes)

Applies to Federal Employee Program plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Initial approval for Type 2 Diabetes

All of:

Diagnosis of type 2 diabetes mellitus
No dual therapy with other GLP-1 receptor agonists

Plus any one of:

HbA1c ≥ 6.5%
History of fasting plasma glucose (FPG) ≥ 126 mg/dL
History of 2-hour glucose ≥ 200 mg/dL during oral glucose tolerance test (OGTT)
History of symptoms of hyperglycemia (polyuria, polydipsia, polyphagia) or hyperglycemic crisis AND random plasma glucose ≥ 200 mg/dL

Renewal for Type 2 Diabetes

All of:

Diagnosis of type 2 diabetes mellitus
Glycemic control has improved or stabilized while on therapy
No dual therapy with other GLP-1 receptor agonists

Documentation to bring

Documentation of type 2 diabetes mellitus diagnosis
ONE of the following lab results: HbA1c ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, 2-hour OGTT glucose ≥ 200 mg/dL, or random plasma glucose ≥ 200 mg/dL with symptoms of hyperglycemia or hyperglycemic crisis
Attestation of no concurrent use of other GLP-1 receptor agonists

Quantity limits

all strengths — 3 units per 84 days (84-day)

Approval and renewal

Initial approval: 12 months
Renewal: every 12 months
Renewal: Improvement in A1C.
Renewal: Glycemic control has improved or stabilized while on therapy. No dual therapy with other GLP-1 receptor agonists. T2DM diagnosis is re-verified at continuation.

Not covered when

Dual therapy with other GLP-1 receptor agonists
Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Type 1 diabetes

Policy note: This policy covers Ozempic only for type 2 diabetes. Although Ozempic has FDA-approved indications for CV risk reduction in T2DM patients with established CVD and for CKD, this policy document (policy 5.30.086) addresses only the antidiabetic indication and does not establish separate PA criteria for those additional indications. The policy does not mention Wegovy or Zepbound for weight loss. The document covers only the antidiabetic GLP-1 class under this policy number. Per FEP policy history, liraglutide (Victoza) formulary exception requirement was removed in December 2024. Ozempic quantity limit is 3 units per 84 days.

Policy effective July 1, 2025 · verified June 5, 2026 · source: 5 30 086 Antidiabetic GLP-1 Gip Agonists · View policy document (PDF)

Does FEP Blue cover Ozempic for Type 2 Diabetes?

Policy document