What is the Medicare GLP-1 Bridge?
It is a temporary Medicare program, available nationwide from July 1, 2026 through December 31, 2027. People with Medicare drug coverage who qualify can get certain GLP-1 drugs for weight management for a $50 copay each month.
The Bridge works outside your regular Part D benefit. The Part D deductible does not apply, the $50 does not count toward your yearly Part D out-of-pocket limit, and Extra Help does not lower it.
Which drugs does it cover?
- Wegovy, as an injection or a tablet
- Zepbound KwikPen. Zepbound vials and single-dose pens are not covered.
- Foundayo tablets
Who qualifies?
| Body mass index (BMI) | You also need |
|---|---|
| 35 or higher | No other condition |
| 30 or higher | Heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher |
| 27 or higher | Prediabetes, a past heart attack or stroke, or peripheral artery disease with symptoms |
You also need Medicare drug coverage through a stand-alone Part D plan, a Medicare Advantage HMO or PPO plan with drug coverage, a Special Needs Plan, an employer or union group Part D plan, or the LI NET program.
Who does not qualify?
- People who already get a GLP-1 drug covered by their Part D plan
- People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease. Their Part D plan may cover a GLP-1 drug for those conditions instead.
How do I get it?
Talk with your doctor or other provider. They send the prescription to your pharmacy, complete a prior authorization when asked and certify that you are using the drug as part of a lifestyle program focused on diet and exercise. You get a letter in the mail when your drug is covered under the Bridge.
The approval lasts through December 31, 2027, including refills and dose changes, unless you switch to a different GLP-1 drug. Your pharmacy may ask for your Medicare Number or the last 4 digits of your Social Security Number.
What happens after 2027?
The Bridge is set to end December 31, 2027. A longer-term Medicare model for these drugs in Part D, called BALANCE, was delayed and will not start in Part D in 2027.
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