06/12/2026
Are you struggling with weight loss or getting GLP-1s approved?
New program coming out. Everyone on Medicare may qualify for this program.
The Medicare GLP-1 Bridge is a temporary, nationwide CMS payment demonstration running from July 1, 2026, to December 31, 2027. It allows eligible Medicare Part D beneficiaries to access certain FDA-approved obesity medications for a flat $50 monthly copayment.Key Details & EligibilityCovered Medications: Foundayo, Wegovy (injection/tablets), and Zepbound (KwikPen).Eligibility: To qualify, you must be at least 18 years old, actively enrolled in an eligible Part D plan (like a standalone PDP or Medicare Advantage drug plan), and prescribed the drug for weight loss.Clinical Criteria: You must have a BMI of 35 or higher, OR a BMI of 30-34.9 combined with a diagnosis of heart failure, uncontrolled hypertension, or chronic kidney disease (stage 3a or above).Part D Exclusions: This bridge is only for weight management. If you need a GLP-1 for Type 2 diabetes or heart risk reduction, it should go through standard Part D coverage.How to Access ItTalk to Your Doctor: Your provider will submit a prior authorization request and your prescription directly to the CMS central processor (outside of your regular Part D plan).Visit Your Pharmacy: CMS uses a specific billing network separate from your standard plan. Your pharmacy will submit the claim to the bridge processor to coordinate your medication release.Because this program operates outside the standard Part D coverage, the $50 copay does not count toward your out-of-pocket maximums