05/28/2026
What is the Medicare GLP-1 Bridge?
The Medicare GLP-1 Bridge is a short-term demonstration run by CMS that will provide eligible Medicare Part D beneficiaries with access to certain GLP-1 drugs between July 1, 2026, and December 31, 2027.
The Medicare GLP-1 Bridge will operate outside of the Medicare Part D benefit’s coverage and payment flow. As a result, Part D sponsors will not carry risk for eligible GLP-1 drugs furnished under the Medicare GLP-1 Bridge, and Part D sponsors do not have to opt in to the Medicare GLP-1 Bridge for eligible beneficiaries to access these drugs beginning July 1, 2026. In 2026, CMS will use a single central processor to manage prior authorization, claims adjudication, and payment to pharmacies for the Medicare GLP-1 Bridge.
Beginning July 1, 2026, all formulations of Foundayo®, all formulations of Wegovy®, and the KwikPen ® formulation of Zepbound® will be available to eligible beneficiaries through the Medicare GLP-1 Bridge. The single-dose vial and single-dose pen formulations of Zepbound® will NOT be available through the Medicare GLP-1 Bridge.
https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge
https://youtu.be/_xtjXIoxwYk?si=XywQhp_nesbthaDA
On July 1st, CMS will be launching the “Medicare GLP-1 Bridge short-term demonstration” – a pilot program that will provide eligible Medicare Part D benefici...