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Zepbound HSA/FSA Eligibility and Submission: Complete 2026 Guide

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8 linked public sourcesEditorial, sourcing, and corrections policy

At a glance

  • Drug / Zepbound (tirzepatide), once-weekly subcutaneous injection [2]
  • Class / dual GIP and GLP-1 receptor agonist [2]
  • Labeled uses / chronic weight management; moderate-to-severe OSA in adults with obesity [2]
  • Status / FDA-approved prescription drug [2]
  • IRS reference / Publication 502 lists drugs, medicines and weight-loss programs among medical expenses [1]

The drug side: two labeled uses

The label says Zepbound is indicated with a reduced-calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight plus at least one weight-related comorbid condition [2]. It is also indicated to treat moderate-to-severe obstructive sleep apnea in adults with obesity [2].

The tax side: Publication 502

IRS Publication 502 is the agency's guidance on medical and dental expenses. Its section on includible medical expenses has entries for drugs, medicines and weight-loss programs [1].

Compounded tirzepatide is a separate question

Compounded drugs are not FDA approved, and FDA says it does not review them for safety, effectiveness or quality before marketing [5]. FDA declared the tirzepatide shortage resolved on December 19, 2024 [6]. Since then a state-licensed pharmacy may compound for an individual patient on a prescription. A product that is essentially a copy of the approved drug is allowed only if it is not made regularly or in inordinate amounts, or if the prescriber documents a significant difference for that patient. FDA says it does not intend to act against four or fewer such prescriptions a month [6]. Outsourcing facilities generally cannot compound from bulk substances unless the substance is on FDA's bulks list or the drug is on the shortage list, and FDA says tirzepatide is on neither [6]. On April 30, 2026, FDA proposed excluding semaglutide, tirzepatide and liraglutide from the bulks list, with comments due June 29, 2026 [7].

Frequently asked questions

What is Zepbound approved to treat?
The label lists chronic weight management in adults with obesity, or overweight plus a weight-related condition, and moderate-to-severe obstructive sleep apnea in adults with obesity, each with a reduced-calorie diet and increased physical activity [2].
Is Mounjaro labeled for the same uses as Zepbound?
No. They are separate products with separate labels. Mounjaro is approved to improve glycemic control in adults and pediatric patients 10 years and older with type 2 diabetes, and to reduce major cardiovascular events in adults with type 2 diabetes at high risk. It is not labeled for weight loss. Weight management and sleep apnea are Zepbound indications [2].
What changed for compounded tirzepatide in 2026?
On April 30, 2026, FDA proposed excluding semaglutide, tirzepatide and liraglutide from the list of bulk substances outsourcing facilities may compound with, finding no clinical need. Comments were due June 29, 2026, and a final decision was not found [7].

References

  1. Publication 502 (2025), Medical and Dental Expenses | Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses | Internal Revenue Service
  2. U.S. National Library of Medicine, DailyMed. Zepbound injection (tirzepatide) prescribing information. Zepbound injection (tirzepatide) label
  3. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022;387(3):205-216. Tirzepatide Once Weekly for the Treatment of Obesity
  4. Malhotra A, Grunstein RR, Fietze I, Weaver TE, Redline S, Azarbarzin A, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024;391(13):1193-1205. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
  5. FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss | FDA. FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss | FDA
  6. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize | FDA. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize | FDA
  7. FDA Proposes to Exclude Semaglutide, Tirzepatide, and Liraglutide on Bulks List | FDA. FDA Proposes to Exclude Semaglutide, Tirzepatide, and Liraglutide on Bulks List | FDA
  8. FDA Approves New Medication for Chronic Weight Management | FDA. FDA Approves New Medication for Chronic Weight Management | FDA
Evidence overview for Zepbound HSA/FSA Eligibility and Submission: Complete 2026 Guide