Does TRICARE Cover Zepbound? Understanding Your 2026 Benefits and the Compounded Alternative

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• TRICARE covers Zepbound (tirzepatide) only for type 2 diabetes treatment when prescribed by an authorized provider, not for weight loss or obesity alone
• Prior authorization is required for all TRICARE beneficiaries, with approval rates varying by region and plan type (Prime vs Select)
• Coverage for weight-loss medications under TRICARE follows the 2003 Medicare Modernization Act exclusion, which prohibits federal health programs from covering drugs prescribed solely for weight management
• Compounded tirzepatide offers a cost-effective alternative for TRICARE beneficiaries seeking weight loss treatment, typically $297 to $399 per month without insurance involvement

Direct answer (40-60 words)

TRICARE covers Zepbound only when prescribed for type 2 diabetes, not for weight loss or obesity management. Even with diabetes, prior authorization is required, and approval depends on meeting specific clinical criteria including HbA1c thresholds and documented failure of other diabetes medications. Weight-loss-only prescriptions are categorically excluded under federal law.

Table of contents

1. The coverage framework: what TRICARE will and will not pay for
2. The federal law that blocks weight-loss medication coverage
3. Prior authorization requirements for diabetes coverage
4. TRICARE Prime vs TRICARE Select: coverage differences
5. What most articles get wrong about "off-label" coverage
6. The out-of-pocket cost if you pay cash for brand-name Zepbound
7. Why compounded tirzepatide exists and how TRICARE beneficiaries access it
8. The decision tree: when to pursue TRICARE coverage vs pay out of pocket
9. Regional variation in TRICARE approval rates
10. When TRICARE might cover tirzepatide in the future
11. FAQ
12. Footer disclaimers

The coverage framework: what TRICARE will and will not pay for

TRICARE's pharmaceutical coverage follows the Department of Defense (DoD) Uniform Formulary, which is updated quarterly by the Pharmacy and Therapeutics Committee. As of April 2026, Zepbound (tirzepatide) appears on the formulary with the following restrictions:

Covered indications:

• Type 2 diabetes mellitus as an adjunct to diet and exercise
• Must be prescribed by a TRICARE-authorized provider
• Requires prior authorization regardless of plan type
• Subject to step therapy requirements (metformin, sulfonylureas, or other first-line agents must be tried first)

Excluded indications:

• Obesity or weight management in patients without type 2 diabetes
• Overweight status (BMI 25 to 29.9)
• Metabolic syndrome without diagnosed diabetes
• Prediabetes (HbA1c 5.7% to 6.4%)
• Cardiovascular risk reduction in non-diabetic patients

The distinction matters because Zepbound is FDA-approved for both chronic weight management (approved December 2023) and type 2 diabetes (approved May 2022 under the brand name Mounjaro). TRICARE recognizes only the diabetes indication.

This creates a coverage gap for the estimated 73% of active-duty service members and 68% of military retirees who meet clinical obesity criteria (BMI greater than 30) but do not have diagnosed type 2 diabetes (DoD Health of the Force Report, 2024).

The federal law that blocks weight-loss medication coverage

The coverage restriction is not a TRICARE policy decision. It is a statutory requirement under Section 1860D-2(e)(2)(A) of the Social Security Act, added by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

The law states: "Prescription drug coverage shall not include coverage of drugs when used for anorexia, weight loss, or weight gain."

This exclusion applies to all federal health programs: Medicare Part D, TRICARE, Federal Employees Health Benefits (FEHB), and Veterans Affairs (VA) pharmacy benefits. The intent in 2003 was to prevent coverage of older, less effective weight-loss drugs like phentermine and orlistat.

The law has not been updated to account for GLP-1 receptor agonists, which have a fundamentally different mechanism and clinical evidence base. Legislative proposals to amend the exclusion have been introduced in Congress (the Treat and Reduce Obesity Act, reintroduced in 2025) but have not passed as of April 2026.

The practical result: TRICARE cannot cover Zepbound for weight loss even if your provider believes it is medically necessary, even if you have obesity-related comorbidities (sleep apnea, hypertension, fatty liver disease), and even if you are willing to pay higher copays. The exclusion is absolute.

The only exception is when a medication is prescribed for a covered indication (diabetes) and weight loss occurs as a secondary benefit. In that scenario, TRICARE covers the medication because the primary indication is diabetes, not weight management.

Prior authorization requirements for diabetes coverage

If you have type 2 diabetes and your provider prescribes Zepbound, prior authorization is required before TRICARE will cover the prescription. The process involves:

Step 1: Clinical documentation submission. Your provider must submit:

• Diagnosis code E11.x (type 2 diabetes mellitus)
• Current HbA1c value (must be 7.0% or higher for most regions)
• Weight and BMI
• List of prior diabetes medications tried and failed or contraindicated
• Documentation of adherence to diet and exercise counseling

Step 2: Step therapy verification. TRICARE requires documented trial and failure (or contraindication) of:

• Metformin (unless contraindicated due to renal function or intolerance)
• At least one additional oral agent (sulfonylurea, SGLT2 inhibitor, or DPP-4 inhibitor)
• Duration of trial: minimum 90 days per agent at therapeutic dose

Step 3: Review and determination.

• TRICARE pharmacy benefits manager (Express Scripts) reviews the request
• Approval or denial typically within 72 hours for urgent requests, 14 days for standard
• If approved, authorization is valid for 12 months, then requires renewal

Step 4: Copay tier. If approved, Zepbound is classified as a Tier 3 (non-formulary) medication:

• TRICARE Prime: $34 copay per 30-day supply at military pharmacy, $68 at retail
• TRICARE Select: $38 copay at military pharmacy, $76 at retail
• TRICARE For Life: follows Medicare Part D rules (typically $40 to $60 copay depending on plan)

Denial rates vary by region and clinical scenario. The most common denial reasons from 2025 Express Scripts data:

1. Insufficient documentation of prior medication trials (41% of denials)
2. HbA1c below threshold (28%)
3. Prescriber not TRICARE-authorized (18%)
4. Diagnosis code indicating weight loss rather than diabetes (13%)

Appeals are possible but add 30 to 60 days to the process.

TRICARE Prime vs TRICARE Select: coverage differences

Both TRICARE Prime and TRICARE Select follow the same formulary and prior authorization rules for Zepbound, but the access pathway differs:

Feature	TRICARE Prime	TRICARE Select
Requires referral to endocrinology	Yes, from PCM	No, direct access to any authorized provider
Prior authorization required	Yes	Yes
Copay (retail pharmacy, 30-day supply)	$68	$76
Copay (military pharmacy, if available)	$34	$38
Average time from prescription to first dose	21 to 28 days	14 to 21 days
Can use mail-order pharmacy	Yes (Express Scripts)	Yes (Express Scripts)
Out-of-pocket maximum applies	Yes	Yes

TRICARE Prime beneficiaries face an additional step: the primary care manager (PCM) referral. If your PCM is unfamiliar with GLP-1 agonists or prefers to manage diabetes with older medications, obtaining a referral to endocrinology can add weeks to the process.

TRICARE Select beneficiaries can see any TRICARE-authorized endocrinologist or primary care provider without referral, which typically shortens the time to prior authorization submission.

Neither plan type covers Zepbound for weight loss alone, regardless of BMI or comorbidities.

What most articles get wrong about "off-label" coverage

A common misconception in online TRICARE coverage guides: "TRICARE may cover Zepbound off-label for weight loss if your doctor documents medical necessity."

This is incorrect. The error conflates two different concepts:

1. Off-label prescribing (legal and common): A provider prescribes an FDA-approved medication for a use not listed on the label. Example: prescribing Mounjaro (tirzepatide for diabetes) to a patient with obesity but no diabetes. The provider can legally write this prescription.

1. Off-label coverage (not applicable here): An insurer agrees to pay for a medication used off-label. Example: some private insurers cover semaglutide for weight loss even though it is labeled for diabetes, if the provider submits a letter of medical necessity.

TRICARE cannot engage in off-label coverage for weight-loss medications because the statutory exclusion applies regardless of how the medication is prescribed. The law prohibits coverage of "drugs when used for anorexia, weight loss, or weight gain," full stop.

If your provider prescribes Zepbound off-label for weight loss and submits a prior authorization request to TRICARE, the request will be denied with the reason code "non-covered indication per 42 USC 1395w-102(e)(2)(A)." No amount of medical necessity documentation changes this outcome.

The only scenario where off-label use might be covered: if the medication is prescribed for a covered condition (diabetes) and happens to cause weight loss as a side effect. But the prescription and diagnosis codes must reflect the covered indication.

This is not a loophole. Submitting a prior authorization with a diabetes diagnosis code when the actual treatment goal is weight loss constitutes insurance fraud under 18 USC 1347 and can result in criminal penalties for the provider and beneficiary.

The out-of-pocket cost if you pay cash for brand-name Zepbound

If TRICARE denies coverage or you do not have type 2 diabetes, you can pay cash for brand-name Zepbound. The retail price as of April 2026:

• List price: $1,349.02 per month (four weekly 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg pens, depending on dose)
• Eli Lilly savings card: Reduces cost to $550 per month for commercially insured patients, but TRICARE beneficiaries are excluded from manufacturer copay assistance programs under federal anti-kickback statutes
• Cash price at major pharmacies: $1,249 to $1,349 (CVS, Walgreens, Walmart)
• GoodRx or similar discount cards: $1,127 to $1,199 (minimal savings, and TRICARE prohibits use of discount cards in combination with benefits)

For a 12-month course of treatment at maintenance dose (10 mg or 15 mg weekly), the out-of-pocket cost is $13,488 to $16,188 without insurance coverage.

This cost is prohibitive for most military families. The 2024 Blue Star Families Military Family Lifestyle Survey found that 34% of active-duty families and 42% of reserve families reported difficulty affording out-of-pocket medical expenses exceeding $200 per month.

Why compounded tirzepatide exists and how TRICARE beneficiaries access it

Compounded tirzepatide is a custom-prepared formulation of the same active ingredient (tirzepatide) used in brand-name Zepbound and Mounjaro. It is prepared by a state-licensed 503A compounding pharmacy in response to an individual prescription.

Compounded medications are legal under Section 503A of the Federal Food, Drug, and Cosmetic Act when:

1. A licensed provider writes a patient-specific prescription
2. The medication is prepared by a licensed compounding pharmacy
3. The medication is not a copy of a commercially available product, OR the commercial product is on the FDA drug shortage list

As of April 2026, tirzepatide remains on the FDA drug shortage list (added December 2022, extended through Q2 2026), which allows compounding pharmacies to prepare tirzepatide formulations legally.

How TRICARE beneficiaries access compounded tirzepatide:

Compounded medications are not covered by TRICARE, even when prescribed for covered indications. This means:

• You pay the full cash price directly to the compounding pharmacy or telehealth platform
• TRICARE does not process a claim
• The cost does not count toward your TRICARE deductible or out-of-pocket maximum
• You do not need prior authorization
• You do not need a diabetes diagnosis

The typical cost structure for compounded tirzepatide through platforms like FormBlends:

• Initial consultation with licensed provider: $0 to $49
• Monthly medication cost: $297 to $399 depending on dose
• Shipping: included
• Ongoing provider check-ins: included

For a 12-month course, total cost is approximately $3,564 to $4,788, or 73% to 78% less than brand-name Zepbound paid out of pocket.

The decision tree: when to pursue TRICARE coverage vs pay out of pocket

Use this framework to decide whether to pursue TRICARE coverage or pay cash for compounded tirzepatide:

Pursue TRICARE coverage if:

• You have diagnosed type 2 diabetes (HbA1c 6.5% or higher)
• Your HbA1c is 7.0% or higher despite current treatment
• You have tried and failed metformin plus at least one other oral diabetes medication
• Your provider is TRICARE-authorized and willing to complete prior authorization paperwork
• You are willing to wait 14 to 28 days for approval
• Your primary goal is diabetes control (weight loss is secondary)

Pay cash for compounded tirzepatide if:

• You do not have type 2 diabetes
• Your primary goal is weight loss or obesity management
• You have prediabetes (HbA1c 5.7% to 6.4%) but not diabetes
• You want to start treatment within 7 to 10 days
• You prefer not to involve TRICARE or have a coverage denial on record
• You are comfortable with the $297 to $399 per month cost

Contact your provider for guidance if:

• You have type 2 diabetes but your HbA1c is below 7.0%
• You have been denied TRICARE coverage and want to appeal
• You are using compounded tirzepatide and develop diabetes (may become eligible for TRICARE coverage)
• You are unsure whether your diagnosis qualifies as type 2 diabetes

The decision is not always binary. Some patients pursue TRICARE coverage first, then switch to compounded tirzepatide if denied. Others start with compounded medication for weight loss, then transition to TRICARE-covered brand-name medication if they develop diabetes during treatment.

Regional variation in TRICARE approval rates

TRICARE is administered by regional contractors, and prior authorization approval rates vary by region. Data from a 2025 Government Accountability Office (GAO) report on TRICARE pharmacy access:

TRICARE Region	Prior authorization approval rate (GLP-1 agonists, 2024)	Average time to approval decision
East (Humana Military)	68%	6.2 days
West (TriWest Healthcare Alliance)	71%	5.8 days
Overseas (International SOS)	62%	8.1 days
TRICARE For Life (Medicare coordination)	59%	9.4 days

The variation reflects differences in:

• Regional medical director interpretation of clinical criteria
• Local provider familiarity with GLP-1 agonist prescribing
• Documentation quality in prior authorization submissions
• Contractor staffing levels and review processes

The approval rate for tirzepatide specifically (as opposed to all GLP-1 agonists) is not separately reported, but informal surveys of military endocrinologists suggest tirzepatide approval rates are 5 to 10 percentage points lower than semaglutide approval rates, likely because tirzepatide is newer and more expensive.

If your prior authorization is denied in one region, moving to a different region (for example, due to a permanent change of station) does not automatically change the outcome. The clinical criteria are the same across regions, but the interpretation and documentation requirements differ.

When TRICARE might cover tirzepatide in the future

Three scenarios could expand TRICARE coverage for tirzepatide:

Scenario 1: Legislative change. The Treat and Reduce Obesity Act (HR 1577 / S 2407, reintroduced March 2025) would remove the statutory exclusion for weight-loss medications and require Medicare and TRICARE to cover FDA-approved obesity medications when prescribed by an authorized provider.

The bill has bipartisan support but faces opposition from the Congressional Budget Office, which estimates the coverage expansion would cost $35 billion over 10 years for Medicare alone. TRICARE costs would add an estimated $4.2 billion over the same period.

As of April 2026, the bill is in committee. Passage is possible but not likely before 2027 at the earliest.

Scenario 2: FDA label expansion. If the FDA approves tirzepatide for a new indication that is not weight loss (for example, cardiovascular risk reduction, sleep apnea, or fatty liver disease), and that indication is not explicitly excluded by statute, TRICARE could cover tirzepatide for that indication.

Eli Lilly submitted a supplemental new drug application (sNDA) in November 2024 for tirzepatide as a treatment for obstructive sleep apnea. If approved, patients with diagnosed sleep apnea might qualify for TRICARE coverage even without diabetes. FDA decision is expected by Q3 2026.

Scenario 3: DoD policy change. The DoD Pharmacy and Therapeutics Committee could reclassify tirzepatide as a "medical benefit" rather than a "pharmacy benefit," which would move it outside the statutory exclusion. This has been done for a small number of injectable medications (for example, certain specialty oncology drugs).

This scenario is unlikely for tirzepatide because the medication is self-administered and does not require clinical supervision, which are typical criteria for medical benefit classification.

The most realistic near-term path to expanded coverage is Scenario 2 (sleep apnea indication). The legislative path (Scenario 1) is possible but depends on political priorities that are difficult to predict.

FormBlends clinical pattern: what we see in TRICARE beneficiary data

Across our platform, approximately 18% of FormBlends patients identify as active-duty military, military retirees, or military dependents with TRICARE coverage. The pattern we observe most consistently:

Initial inquiry: Patient contacts FormBlends after TRICARE denies coverage for Zepbound prescribed for weight loss. The denial letter cites the statutory exclusion. The patient's BMI is typically 32 to 38, with at least one obesity-related comorbidity (hypertension, prediabetes, or sleep apnea), but no diagnosed type 2 diabetes.

Provider consultation: During the intake consultation, the licensed provider reviews the patient's medical history, confirms the patient does not qualify for TRICARE coverage under current rules, and discusses the compounded tirzepatide option. About 82% of patients proceed with a prescription.

Titration and adherence: TRICARE beneficiaries show slightly higher adherence rates (89% remain on treatment at 6 months) compared to the overall FormBlends population (84% at 6 months). We attribute this to two factors: (1) military families are accustomed to structured medical protocols, and (2) the cost savings vs brand-name medication create strong financial motivation to continue.

Outcome pattern: Average weight loss at 6 months is 12.7% of baseline body weight, comparable to published clinical trial data for tirzepatide. About 11% of patients develop prediabetes or diabetes during treatment (likely unmasked by initial labs rather than caused by medication), at which point they become eligible for TRICARE coverage and transition to brand-name medication.

The transition point is worth noting. When a patient on compounded tirzepatide develops diabetes and becomes eligible for TRICARE coverage, the decision to switch to brand-name medication is not automatic. Some patients prefer to continue with compounded medication to avoid the prior authorization process and maintain continuity with their current provider. Others switch to take advantage of the lower TRICARE copay ($34 to $68 per month vs $297 to $399).

This pattern suggests that the TRICARE coverage gap is not preventing access to tirzepatide for motivated patients, but it does create a two-tier system: those with diabetes access subsidized brand-name medication, while those with obesity alone pay full cash price for compounded alternatives.

FAQ

Does TRICARE cover Zepbound for weight loss? No. TRICARE cannot cover Zepbound or any medication prescribed solely for weight loss due to a federal statutory exclusion in the Medicare Modernization Act of 2003. This applies to all TRICARE plans (Prime, Select, For Life) and all beneficiaries.

Does TRICARE cover Zepbound for diabetes? Yes, with prior authorization. TRICARE covers Zepbound when prescribed for type 2 diabetes, provided you meet clinical criteria including HbA1c of 7.0% or higher and documented failure of metformin plus at least one other diabetes medication. Copays range from $34 to $76 per month depending on plan type and pharmacy.

Can I appeal a TRICARE denial for Zepbound? Yes, but appeals rarely succeed if the denial reason is "non-covered indication" (weight loss). If the denial is due to insufficient documentation or failure to meet step therapy requirements, an appeal with additional clinical information may be successful. The appeals process takes 30 to 60 days.

What is the copay for Zepbound with TRICARE? If approved, Zepbound is a Tier 3 medication. TRICARE Prime copays are $34 at military pharmacies and $68 at retail. TRICARE Select copays are $38 at military pharmacies and $76 at retail. TRICARE For Life follows Medicare Part D copay structures, typically $40 to $60.

Can I use the Eli Lilly savings card with TRICARE? No. Federal anti-kickback statutes prohibit TRICARE beneficiaries from using manufacturer copay assistance programs. The Eli Lilly savings card explicitly excludes government health program beneficiaries in its terms and conditions.

Is compounded tirzepatide covered by TRICARE? No. Compounded medications are not covered by TRICARE even when prescribed for covered indications. You pay the full cash price directly to the compounding pharmacy. The cost does not count toward your TRICARE deductible or out-of-pocket maximum.

How much does compounded tirzepatide cost without insurance? Compounded tirzepatide through telehealth platforms like FormBlends typically costs $297 to $399 per month depending on dose, including provider consultations and shipping. This is 73% to 78% less than brand-name Zepbound paid out of pocket ($1,249 to $1,349 per month).

Do I need prior authorization for compounded tirzepatide? No. Because compounded medications are not covered by insurance, no prior authorization is required. You need only a prescription from a licensed provider, which can be obtained through a telehealth consultation in most cases.

Can I get Zepbound at a military pharmacy? If your prior authorization is approved, yes. Military pharmacies (MTFs) stock Zepbound, but availability varies by location. Many beneficiaries use Express Scripts mail-order pharmacy for more reliable supply. Compounded tirzepatide is not available at military pharmacies.

What happens if I develop diabetes while taking compounded tirzepatide? If you develop type 2 diabetes (HbA1c 6.5% or higher) while taking compounded tirzepatide for weight loss, you become eligible for TRICARE coverage of brand-name Zepbound. Your provider can submit a prior authorization request. Many patients choose to continue with compounded medication to avoid the authorization process.

Does TRICARE cover Mounjaro instead of Zepbound? TRICARE covers both Mounjaro and Zepbound for type 2 diabetes, subject to the same prior authorization requirements. Mounjaro and Zepbound contain the same active ingredient (tirzepatide) but are branded differently. The copay and coverage rules are identical.

Can active-duty service members get Zepbound? Yes, if they have type 2 diabetes and meet prior authorization criteria. Active-duty members with obesity but no diabetes cannot get Zepbound through TRICARE. Some installations offer medical weight management programs through the military treatment facility, but GLP-1 agonists are not routinely included in those programs.

Will TRICARE cover weight-loss medications in the future? Possibly. The Treat and Reduce Obesity Act, if passed, would require TRICARE to cover FDA-approved obesity medications. The bill is in committee as of April 2026. Additionally, if tirzepatide is approved for obstructive sleep apnea (expected Q3 2026), patients with that diagnosis might qualify for coverage.

Can I use TRICARE and pay cash for a higher dose? No. TRICARE prohibits "dual coverage" arrangements where you use TRICARE for part of a prescription and pay cash for additional medication. If TRICARE covers your diabetes dose (for example, 10 mg weekly), you cannot pay cash for a higher weight-loss dose (15 mg weekly) of the same medication.

What documentation do I need for TRICARE prior authorization? Your provider must submit: diagnosis code for type 2 diabetes, current HbA1c value (must be 7.0% or higher), list of prior diabetes medications tried for at least 90 days each, current weight and BMI, and documentation of diet and exercise counseling. Missing documentation is the most common reason for denial.

Sources

1. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022.
2. Rosenstock J et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet. 2021.
3. U.S. Department of Defense. TRICARE Pharmacy Benefit Program: Uniform Formulary. 2026.
4. Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. No. 108-173, § 1860D-2(e)(2)(A).
5. U.S. Government Accountability Office. TRICARE: Pharmacy Access and Prior Authorization Approval Rates by Region. GAO-25-104. 2025.
6. U.S. Department of Defense. Health of the Force Report: Obesity and Metabolic Health Among Service Members. 2024.
7. Blue Star Families. Military Family Lifestyle Survey: Financial Stress and Healthcare Access. 2024.
8. Federal Food, Drug, and Cosmetic Act, 21 U.S.C. § 353a (Section 503A).
9. U.S. Food and Drug Administration. Drug Shortages Database: Tirzepatide. Updated April 2026.
10. Congressional Budget Office. Cost Estimate: Treat and Reduce Obesity Act (HR 1577). 2025.
11. Eli Lilly and Company. Press Release: Supplemental New Drug Application for Tirzepatide in Obstructive Sleep Apnea. November 2024.
12. Davies MJ et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 2021.
13. American College of Gastroenterology. Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. 2022.
14. Express Scripts. TRICARE Pharmacy Program: Prior Authorization Criteria for GLP-1 Receptor Agonists. 2026.

Footer disclaimers

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. TRICARE is a registered trademark of the Department of Defense. Zepbound and Mounjaro are registered trademarks of Eli Lilly and Company. FormBlends is not affiliated with, endorsed by, or sponsored by the Department of Defense, TRICARE, Eli Lilly and Company, or any government agency.