05/08/2026
Medicare GLP-1 Bridge. What is it?
Starting July 2026, CMS will start a short-term model to allow certain Medicare beneficiaries access to GLP-1 meds for $50 per month.
The program will run July 1, 2026, through December 31, 2027.
Who can qualify?
The beneficiary is at least eighteen (18) years of age and has a BMI greater than or equal to thirty-five (≥35) at the time of initiation of GLP-1 therapy, or the beneficiary is at least eighteen (18) years of age and has a BMI greater than or equal to thirty (≥30) at the time of initiating GLP-1 therapy with a
diagnosis of one or more of the following: (A) heart failure with preserved ejection fraction, (B) uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg, despite concurrent treatment with two antihypertensive medications), or (C) chronic kidney disease stage 3a or above, or the beneficiary is at least eighteen (18) years of age and has a BMI greater than or equal to twenty-seven (≥27) at the time of initiating GLP-1 therapy with a diagnosis of one or more of the following: (A) pre-diabetes (as defined by American Diabetes Association guidelines), (B) previous myocardial infarction, (C) previous stroke, or (D) symptomatic peripheral artery disease.
What GLPs are included?
At this time, for the purposes of the Medicare GLP-1 Bridge, an eligible GLP-1 drug is any of the following products when used to reduce excess body weight and maintain weight reduction: Foundayo®, Wegovy® (injection and tablets), and Zepbound®
(KwikPen®).
Where can I find more information?
CMS has a GLP-1 Bridge Overview site here:
https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-
1-bridge
