Every health plan in the Federal Employees Health Benefits Program, known as FEHB, must cover at least one GLP-1 weight-loss drug in 2027, according to the Office of Personnel Management. Plans must also cover at least two oral anti-obesity medications. The catch is a new therapy requirement that patients will have to meet before and during treatment.
What OPM is requiring from every carrier
OPM laid out the 2027 rules in its open season highlights for plan year 2027, dated September 30. The document says plans must cover “at least one GLP-1 anti-obesity medication and at least two oral anti-obesity medications.” The same language applies to the Postal Service Health Benefits program, known as PSHB.
GLP-1 drugs are a class of medicines used for weight loss and diabetes. OPM does not name a brand in the highlights. Which specific drugs land on each plan’s list will show up in the carriers’ 2027 brochures.
For federal annuitants, the practical question is which of the 118 FEHB plan options handles the drug best. OPM counts 45 carriers offering those plans for 2027. A retiree already taking a GLP-1 for diabetes, or planning to start one for weight loss, will want the brochure drug list in hand before choosing.
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The therapy condition attached to the drugs
OPM says all carriers must require documented participation in an evidence-based intensive behavioral therapy program before and during anti-obesity medication treatment. In plain terms, a prescription alone will not be enough. Patients will need records showing they are in a structured lifestyle program.
Plans must cover that therapy too. The highlights call for individual and group sessions plus medical nutrition therapy, with 12 to 22 sessions covered per year depending on progress. Carriers are also told to coordinate these services with their criteria for medication and for metabolic surgery.
Children are included. Plans must cover qualifying therapy programs for ages 6 and older with a body mass index above the 95th percentile. Those programs must run 26 or more contact hours over 3 to 12 months and track participation, completion, weight change and cardiometabolic outcomes.
What the highlights do not settle
OPM does not set the copay or coinsurance for these drugs. It does not say how prior authorization will work for them either. What it does say is that for obesity, diabetes, hypertension and pain management, prior authorizations or network barriers will be removed when cost-effective.
Those gaps decide what an enrollee actually pays. With no cost-sharing set by OPM, the number will come from each carrier’s brochure. OPM says the 2027 brochures become available on its site in early November.
Premiums are rising alongside the new coverage. OPM puts the average FEHB premium increase for 2027 at 9.3%, with the enrollee share up 10.9% and the government contribution up 8.6%. For PSHB, the average is up 6.7%, with the enrollee share up 8.2%.
Nine FEHB plans are terminating for 2027. Enrollees in those plans who do not choose a new one will default to Compass Rose Standard. Anyone whose current plan is on that list has a deadline whether or not weight-loss coverage matters to them.
Medicare changes the comparison for retirees
Retirees on Medicare face a second layer. OPM’s Medicare guidance says a FEHB plan that offers Medicare drug benefits automatically enrolls eligible members in Part D at no additional cost, and that those benefits give broader drug access at a lower cost than the drug coverage built into the FEHB plan. A member may be covered by only one Part D or Medicare Advantage plan at a time.
The highlights do not say whether the GLP-1 requirement reaches the Medicare drug benefit some plans offer. Retirees on Medicare should read the brochure’s drug section for both versions of the plan. Canceling FEHB as an annuitant is permanent, according to the same OPM page, so dropping it over a drug list is a one-way decision.
OPM runs a plan comparison tool for ZIP code and enrollee type. The page now shows 2026 plans, and OPM warns it is not the official statement of benefits. The 2027 brochures are the document that governs what a plan owes.
The open season window runs November 9 to December 14, 2026. Annuitant changes take effect January 1, 2027. For active FEHB employees outside the Postal Service, changes take effect January 10, 2027.
OPM’s highlights put the government’s share at 72% of the program-wide weighted average premium, or 75% of the selected plan’s premium, whichever is less. The 10.9% rise in the enrollee share therefore lands on the slice that retirees pay out of their own annuity checks. A plan with a richer drug benefit and a higher premium costs more of that slice.
The Postal Service side has its own list. OPM counts 17 carriers and 65 plan options for PSHB in 2027, and one PSHB plan is terminating, with enrollees defaulting to the Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus if they do not choose another.
The open question for a retiree on Medicare is which plan keeps the weight-loss drug, the doctors and the monthly cost in line at once. No plan will be best on all three, and OPM’s floor of one GLP-1 and two pills sets only the minimum. The December 14 deadline will not move for anyone who is still comparing on the last day.
Which FEHB plan fits a GLP-1 and Medicare by December 14?
A retiree who picks a plan by premium alone can find in January that the weight-loss drug sits on the top tier or that a prior-authorization step blocks the first fill. OPM’s rules set a coverage floor, not a price, and the enrollment window closes December 14.
The Medicare side of that decision is the job The 2027 Medicare Open Enrollment Decision Kit finishes. It includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, and the Open Enrollment calendar with its dates in one place. It works on Medicare plans, not FEHB brochures.
Line up plan costs and dates with the open enrollment kit and its cost calculator →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
