Medicare has launched a temporary demonstration program called the Medicare GLP-1 Bridge to expand access to certain GLP-1 receptor agonist medications (popular weight-loss and metabolic drugs) for eligible beneficiaries. The program aims to provide affordable options for weight management while gathering data for potential longer-term coverage.

Key Dates

  1. Start: July 1, 2026
  2. End: December 31, 2027

The program is nationwide and available in all states and U.S. territories.

Eligible Drugs

Covered medications (when prescribed specifically for weight management/reducing excess body weight and maintaining weight loss, in combination with lifestyle changes):

  1. Wegovy (all formulations)
  2. Zepbound (KwikPen formulation only)
  3. Foundayo (all formulations)

These are provided outside the standard Medicare Part D benefit. Note: If prescribed for conditions like Type 2 diabetes, obstructive sleep apnea, or certain cardiovascular indications already covered under Part D, beneficiaries should use their regular Part D plan instead.

Copays and Costs

  1. Fixed $50 monthly copay for a 30-day supply for eligible beneficiaries.
  2. The copay does not count toward your Part D true out-of-pocket (TrOOP) costs or deductible.
  3. Low-income subsidy (LIS) does not apply here.

Eligibility

You must:

  1. Be enrolled in Medicare Part D (most plans qualify).
  2. Meet clinical criteria (attested by your provider via prior authorization): Age 18+, specific BMI thresholds (≥35 or ≥30/27 with comorbidities like heart issues, hypertension, CKD, etc.), and used with lifestyle changes.
  3. Prescription for weight management only.

How to Access It

  1. No opt-in needed. Doctor submits prior authorization + prescription to the central processor starting July 1, 2026.
  2. Pharmacies handle claims and collect the $50 copay.

Important notes: This is a demonstration project separate from standard Part D. Talk to your doctor about whether this fits your needs.

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This program is a significant step toward making these effective medications more accessible. For official details, visit the CMS Medicare GLP-1 Bridge page.

Always consult your healthcare provider and Medicare resources for advice tailored to your situation.