No. PEEHIP does not cover Wegovy. Alabama’s Public Education Employees’ Health Insurance Plan lists “Anti-Obesity Preparations, Weight Loss Medications” as a general exclusion on its pharmacy benefit, and that exclusion has carried through the plan years effective January 2024, February 2025, and January 2026. The exclusion is written into the plan’s benefit design, so it is not something a prior authorization or appeal is set up to overcome.
The same exclusion sweeps in other drugs marketed for weight loss, including Zepbound (tirzepatide). None of them appear on PEEHIP’s covered formulary.
Why the Express Scripts Drug List Can Mislead You
PEEHIP’s pharmacy benefits are administered by Express Scripts, and the Express Scripts National Preferred Formulary for 2026 does list Wegovy pens, Wegovy tablets, and Zepbound pens as covered. That list does not control your coverage. Express Scripts is a pharmacy benefit manager, not an insurer, and it administers whatever benefit design the employer chooses. Two people holding Express Scripts cards can have completely different drug coverage.
PEEHIP has chosen to exclude anti-obesity medications from its version of the formulary. The national Express Scripts list is not the document to check. The PEEHIP-specific formulary is.
Semaglutide Prescribed for Type 2 Diabetes
Semaglutide is the active ingredient in both Wegovy, which is approved for chronic weight management, and Ozempic, which is approved for type 2 diabetes. PEEHIP’s exclusion targets the anti-obesity and weight loss category. A drug excluded when prescribed for weight loss may still be covered when prescribed for a different approved indication like type 2 diabetes, depending on how the plan processes the claim. The 2026 PEEHIP formulary pages available do not explicitly name Ozempic, and members with questions about semaglutide for diabetes are directed to call Express Scripts at (800) 363-9389.
PEEHIP Medicare Advantage Members
If you are on the PEEHIP Medicare Advantage Plan, your prescription coverage runs through a separate administrator. Humana replaced UnitedHealthcare as that administrator effective January 1, 2026. The available Humana plan documents do not specifically address Wegovy or anti-obesity drug coverage. To confirm, check the Prescription Drug Guide or call Humana PEEHIP Group Medicare Customer Care at 800-747-0008.
What PEEHIP Does Cover for Obesity
Bariatric surgery is available to PEEHIP members, but only at Alabama Blue Distinction Centers. A George Washington University analysis of Alabama’s state employee obesity coverage found that the state plan “will not cover services or expenses for treatment of any condition — including obesity — based upon weight reduction or dietary control whether or not a provider performs or prescribes them,” with bariatric surgery as the sole exception. No pending Alabama legislation has been identified that would require PEEHIP to begin covering GLP-1 weight loss medications, and the 2025–2026 PEEHIP Member Handbook’s plan-year updates make no mention of adding anti-obesity drug coverage.
How to Confirm Coverage for Your Prescription
- Express Scripts Customer Service for active members and non-Medicare-eligible retirees: (800) 363-9389.
- Express Scripts Pharmacy Help Desk: (800) 922-1557.
- PEEHIP searchable formulary for the current plan year: rsa-al.gov, under PEEHIP pharmacy benefits.
- Humana for Medicare Advantage members: 800-747-0008, or your.Humana.com/peehip.
Full details on prescription drug exclusions and limitations are in the PEEHIP Summary Plan Description at rsa-al.gov/peehip/publications/.