06/16/2026
🚨 BIG NEWS for Medicare Beneficiaries! 🚨
Starting July 1, 2026, Medicare is rolling out the GLP-1 Bridge Program — and it could mean major savings on weight-loss medications for millions of people!
💊 WHAT IS IT?
The Medicare GLP-1 Bridge is a temporary CMS demonstration program running from July 1, 2026 through December 31, 2027. It gives eligible Medicare Part D members access to FDA-approved GLP-1 weight-loss medications for just $50/month — no opt-in or registration required!
✅ WHO QUALIFIES?
You may be eligible if you're enrolled in a Medicare Part D plan (standalone PDP or Medicare Advantage with drug coverage) AND meet one of these clinical criteria:
• BMI of 35 or higher
• BMI of 30+ with heart failure, uncontrolled hypertension, or chronic kidney disease (stage 3a or higher)
• BMI of 27+ with pre-diabetes, previous heart attack, previous stroke, or peripheral artery disease
⚠️ Note: Your doctor must submit a prior authorization request confirming you meet the criteria. The clinical criteria are based on when you first started GLP-1 therapy — so even if you've already lost weight, you may still qualify!
💉 COVERED MEDICATIONS:
The following GLP-1 drugs are covered under this program both here in Michigan and nationwide:
🔹 Wegovy® (semaglutide) — injection & tablet forms
🔹 Zepbound® (tirzepatide) — KwikPen® formulation only
🔹 Foundayo® (semaglutide oral) — all formulations
These are the same covered drugs in all 50 states and U.S. territories — the program is 100% nationwide.
❌ NOT COVERED under the Bridge:
• Ozempic® or Mounjaro® (approved for diabetes, not weight loss — covered separately under Part D if prescribed for diabetes)
• Zepbound vials (only the KwikPen® is included in the Bridge)
📅 WHAT'S NEXT?
The Bridge is designed as a transition to the longer-term BALANCE program launching in January 2027. This is a huge step forward for Medicare coverage of obesity treatment!
👋 Have questions about whether YOU qualify, or how this affects your Medicare plan? The "Insurance Professor" Victor Whang and Insurance Warehouse are here to help!
📧 [email protected]
📞 833-SVE-MONY (833-783-6669)
🌐 www.inswh.com
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⚠️ IMPORTANT DISCLAIMER: We do not offer every Medicare plan available in your area. Currently we represent 15 organizations which offer 67 products in your area. Please contact Medicare.gov for more information.
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