TennCare and GLP-1s

What changed, and what the document says

1. The class went on the list

   Covered

   Criteria changed and the drugs joined the preferred drug list on the same date.

   “Prior authorization criteria changes are expected to be effective January 1, 2026, for agents in the GLP-1 Weight Management Therapy class as they are added to the Preferred Drug List (PDL).”

   State of Tennessee Division of TennCare — 12/01/2025

2. Ninety days to start

   Conditions apply

   The first approval used to run longer. From January it runs three months.

   “Beginning January 1, 2026, initial authorizations for GLP-1 Weight Management Therapy agents will change to a 3-month prior authorization (PA) approval duration.”

   State of Tennessee Division of TennCare — 12/01/2025

3. One at a time, enforced at the counter

   Conditions apply

   This is a hard edit at the pharmacy, not a policy sentence. The refill threshold is what lets you switch products.

   “Members may refill a GLP-1 receptor agonist after meeting the 85% refill threshold, including when changing between products or strengths.”

   State of Tennessee Division of TennCare — 12/01/2025

4. Three exceptions a year

   Context

   Titration and product changes get an override, and the allowance is counted.

   “A member may receive up to 3 overrides per rolling calendar year.”

   State of Tennessee Division of TennCare — 12/01/2025

5. Wegovy from age 12

   Covered

   The floor is the label's, and for teenagers the test is a BMI percentile rather than a number.

   “Patient must be the labeled age minimum (Wegovy ≥ 12)”

   State of Tennessee Division of TennCare — September 1, 2026

6. Zepbound from age 18

   Context

   Six years apart, on the same criteria page, for the same use.

   “Patient must be the labeled age minimum (Zepbound ≥ 18)”

   State of Tennessee Division of TennCare — September 1, 2026

7. Obesity is the stated purpose

   Covered

   No diabetes diagnosis, no cardiovascular event, no sleep study. This pathway is about weight and says so.

   “Treatment is for the management of obesity;”

   State of Tennessee Division of TennCare — September 1, 2026

8. Renewal turns on 5 percent

   Conditions apply

   Adults have to show it. Teenagers are measured against BMI-for-age instead.

   “For patients > 18 years of age, submission of medical records (e.g., chart notes) documenting a weight loss of ≥ 5% of baseline body weight”

   State of Tennessee Division of TennCare — September 1, 2026

9. If the renewal fails

   Context

   You don't stop that week. There's a month written into the criteria to come off the dose.

   “Patients not meeting the below renewal criteria may be approved for up to one month to allow for titration off medication”

   State of Tennessee Division of TennCare — September 1, 2026

Which of these companies serve Tennessee?

Of the 387 companies we grade, 34 publish a list of the states they are licensed in. We checked 251 more and found no such list on any page we read; 102 we have not checked either way.

21 of those lists name Tennessee: Gala Health, Care Bare Rx, Vita Bella, TelePeptide, Levity, WePeptideRx, Ways2Well, TeleClinic, Tyde Wellness, Willow, VevaRx, Trimi, HumeCare+, Rx.com, Mojoon, Peak Wellness, Sprout Health, Allara Health, MEDvidi, Gaya Wellness, and Mixx Health & Wellness. That is a licensure claim each company makes about itself, not something we checked with a state board.

A published list is a starting point, not a guarantee. If availability decides your choice, ask before you pay and get the answer in writing.

Coverage decides what you pay before cash does. See how state Medicaid programs cover GLP-1s and what a prior-authorization denial turns on.