Contrave combines naltrexone and bupropion in an extended-release tablet to help adults manage chronic weight issues. Approved by the FDA for long-term use alongside reduced-calorie eating and increased physical activity, it targets brain pathways that control hunger and cravings. Many people find it helpful when diet and exercise alone haven’t delivered lasting results.
For those covered by TRICARE, questions about prescription access often arise, especially with recent policy shifts affecting weight management drugs. Changes implemented in late 2025 adjusted availability based on plan type and medical need. These updates aim to follow federal guidelines while supporting eligible beneficiaries.
This article outlines current TRICARE rules for Contrave, including who qualifies, required steps, potential costs, side effects, and viable alternatives. It provides straightforward details to help you discuss options confidently with your provider and make choices that fit your health journey.
What Is Contrave?
Contrave is a prescription oral medication containing naltrexone hydrochloride and bupropion hydrochloride. It works by influencing appetite signals in the brain to reduce food intake and promote feelings of fullness. The typical dose starts low and increases gradually over four weeks to reach two tablets twice daily.
It’s indicated for adults with a BMI of 30 or higher, or 27 with weight-related conditions like high blood pressure or type 2 diabetes. Contrave isn’t a standalone solution but pairs best with lifestyle changes for sustained weight loss. Clinical studies show average reductions of 5-10% body weight over a year when used properly.
Your doctor evaluates if it suits your profile, considering medical history and other treatments tried. Regular follow-ups track progress and adjust as needed.
How Does Contrave Work?
Contrave combines two active ingredients with complementary effects. Bupropion, an antidepressant, helps curb appetite and may boost energy for activity. Naltrexone, used for addiction treatment, blocks certain reward pathways to lessen food cravings.
Together, they address overeating driven by emotional or habitual factors. This dual mechanism differs from stimulants or hormone-based drugs. Effects build over weeks, with noticeable appetite changes often appearing early.
Consistency matters—take it with food to minimize stomach upset. Pairing with balanced meals and movement enhances outcomes and supports overall well-being.
Does TRICARE Cover Contrave?
Does TRICARE Cover Contrave? Yes, TRICARE covers Contrave for weight management under specific conditions, primarily for beneficiaries enrolled in TRICARE Prime or TRICARE Select, including certain premium-based plans like TRICARE Reserve Select or TRICARE Retired Reserve. Coverage requires an approved prior authorization and demonstration of medical necessity.
As of August 31, 2025, the Defense Health Agency tightened rules, ending coverage for weight loss drugs when obesity is the sole condition for groups like TRICARE For Life beneficiaries and those limited to direct care at military facilities. For eligible plans, Contrave remains accessible with proper documentation from a network provider.
Always use the TRICARE Formulary Search Tool to confirm current status and requirements. Policies focus on supporting evidence-based treatment while aligning with regulations.
Coverage Requirements and Prior Authorization
Prior authorization is essential for Contrave under TRICARE. Your provider submits details including BMI, weight-related comorbidities, and evidence of prior unsuccessful weight loss efforts through diet, exercise, or other approaches.
The process involves Express Scripts, TRICARE’s pharmacy manager, reviewing for clinical appropriateness. Approvals often require ongoing monitoring and continued lifestyle adherence.
If criteria aren’t met initially, additional information can strengthen the request. Appeals exist for denials, with provider support improving chances.
How to Access Contrave Through TRICARE
Begin with a consultation at a TRICARE-authorized provider, such as a military treatment facility or network doctor. Discuss your weight history and why Contrave may help after other methods.
The provider completes and submits the prior authorization form. Once approved, fill at a military pharmacy for lower costs, home delivery for convenience, or retail network locations.
Refills need periodic reauthorization to maintain coverage. Keep communication open for seamless continuation.
Potential Side Effects and Safety Considerations
Common side effects include nausea, constipation, headache, and insomnia, particularly during dose escalation. These often lessen with time, and taking with food helps digestion.
More serious risks involve increased blood pressure, mood changes, or seizures in those with certain histories. Avoid if you have uncontrolled hypertension, eating disorders, or recent opioid use.
Monitor closely and report severe symptoms like persistent headaches or allergic reactions promptly. Your provider guides safe use tailored to your health.
Cost Considerations with TRICARE
For covered beneficiaries, costs depend on plan, pharmacy, and status. Military pharmacies frequently offer low or no copays for approved fills, while home delivery provides 90-day supplies at favorable rates.
Without coverage or for ineligible plans, retail prices exceed $600-800 monthly. Manufacturer programs may offer savings, though TRICARE beneficiaries check eligibility restrictions.
Recent copay adjustments in 2026 eliminated many out-of-pocket fees for covered drugs at certain pharmacies, easing burden for eligible users.
Alternatives to Contrave
Other prescription weight loss options include Qsymia, phentermine for short-term use, or GLP-1 drugs like Saxenda or Wegovy when criteria align. These vary in mechanism, administration, and coverage rules.
Non-medication paths emphasize behavioral programs, nutrition counseling, and exercise support, often covered by TRICARE. Bariatric surgery qualifies for severe cases meeting strict guidelines.
Over-the-counter aids like fiber supplements or meal replacements provide gentle support alongside habits.
| Medication | Active Ingredient | Administration | Primary Use | TRICARE Coverage for Weight Loss (Eligible Plans) | Typical Monthly Cost Without Coverage | Common Side Effects |
|---|---|---|---|---|---|---|
| Contrave | Naltrexone + Bupropion | Oral tablet | Chronic weight management | Yes, with PA | $600–$840 | Nausea, headache, insomnia |
| Qsymia | Phentermine + Topiramate | Oral capsule | Chronic weight management | Yes, with PA | $150–$300 | Dry mouth, tingling, taste changes |
| Wegovy | Semaglutide | Weekly injection | Chronic weight management | Yes, with PA | $1,300+ | Nausea, vomiting, diarrhea |
| Saxenda | Liraglutide | Daily injection | Chronic weight management | Yes, with PA | $1,200+ | Nausea, injection site reactions |
| Phentermine | Phentermine | Oral tablet | Short-term weight loss | Yes, limited duration | $20–$50 | Increased heart rate, insomnia |
| Orlistat (Xenical/Alli) | Orlistat | Oral capsule | Weight loss (OTC version available) | Limited | $50–$200 (prescription) | Oily stools, gas |
This table compares features to aid informed discussions with your provider.
Lifestyle Strategies to Support Weight Management
Build meals around vegetables, lean proteins, and whole grains while controlling portions. Track intake to identify patterns and maintain a calorie deficit safely.
Incorporate regular movement, starting with walks and progressing to strength or cardio sessions. TRICARE covers many preventive services, including counseling.
Prioritize sleep, stress reduction, and hydration for better hormone balance. Consistent small changes compound over time for lasting progress.
Summary
TRICARE covers Contrave for weight management in eligible plans like Prime and Select with prior authorization and medical necessity. Coverage excludes certain groups post-2025 changes, focusing resources on those meeting strict criteria.
Work with your provider to navigate requirements and explore alternatives if needed. Costs stay reasonable through approved channels for covered users, and lifestyle integration boosts any approach.
Professional oversight ensures safe, effective progress toward healthier weight goals.
FAQ
Does TRICARE cover Contrave for weight loss?
TRICARE covers Contrave when prescribed for chronic weight management under TRICARE Prime, Select, or select premium plans. It requires prior authorization, medical necessity, and a network provider prescription. Coverage ended for TRICARE For Life and some other groups after August 31, 2025.
What prior authorization is required for Contrave?
Your provider submits a form to Express Scripts detailing BMI, comorbidities, and failed prior weight loss attempts. Approval confirms appropriateness for your case. Reauthorizations occur periodically to continue benefits.
How much does Contrave cost with TRICARE?
Eligible beneficiaries often pay low or no copays at military pharmacies or home delivery. Recent 2026 changes eliminated many fees for covered prescriptions. Without coverage, retail prices reach $600–$840 monthly.
Can TRICARE For Life beneficiaries get Contrave covered?
No, TRICARE For Life no longer covers Contrave or similar drugs when obesity is the primary reason following 2025 policy updates. Beneficiaries pay full cost or explore alternatives. Diabetes-related uses for other meds remain covered.
What alternatives to Contrave does TRICARE cover?
Options include Qsymia, phentermine (short-term), Wegovy, or Saxenda with prior authorization for eligible plans. Behavioral interventions and nutrition services are often available. Discuss fit based on your needs.
Are there savings options if Contrave isn’t covered?
Manufacturer programs like CurAccess may reduce costs to $99 or less for some, though TRICARE restrictions apply. Discount cards or cash-pay pharmacies help. Consult your provider for tailored affordable paths.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.