OPM to require behavioral therapy before FEHB coverage of obesity drugs
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Starting with the 2027 plan year, the U.S. Office of Personnel Management will require all FEHB and PSHB carriers to make documented participation in intensive behavioral therapy (IBT) a prerequisite for covering anti-obesity medications such as Wegovy and Zepbound, both before and during treatment. Plans are expected to cover 12 to 22 IBT sessions per year for adults, and 26 or more contact hours over 3 to 12 months for children aged 6 and older with a BMI above the 95th percentile. The move follows a December 2025 OPM Inspector General report finding that GLP-1 pharmacy spending rose more than 500% from 2019 to 2024, driving up FEHB premium costs. Federal employees can evaluate how plans administer the new rules during Open Season, which runs November 9 to December 14, 2026.
Written by a model from the reports · updated 2 hours ago
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- reddit.comNew OPM rules for FEHB GLP-1 coverage
Starting with the 2027 plan year, OPM will require all FEHB and PSHB carriers to make documented participation in intensive behavioral therapy a prerequisite for covering anti-obesity medications such as Wegovy and Zepbound, both before and during treatment. Plans are expected to cover 12 to 22 IBT sessions per year for adults, and 26 or more contact hours over 3 to 12 months for children aged 6 and older with a BMI above the 95th percentile. A December 2025 OPM Inspector General report found GLP-1 pharmacy spending rose more than 500% from 2019 to 2024, driving up FEHB premium costs; employees can evaluate plan administration during Open Season from November 9 to December 14, 2026.
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