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Medicare GLP-1 Bridge Program- Affordable Access to Weight Loss Medications
Starting July 1, 2026 - Eligible beneficiaries can access GLP-1 drugs for as low as $50/month
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Download the Prior Authorization form here
MEDICARE GLP-1 BRIDGE PRIOR AUTHORIZATION REQUEST FORM
Who Qualifies?
You must be 18 or older and meet one of these requirements when you start GLP-1 therapy:
- You have a body mass index (BMI) of 35 or higher.
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You have a BMI of 30 or higher and have at least one of these conditions:
- Diastolic heart failure, also called heart failure with preserved ejection fraction.
- Uncontrolled high blood pressure, also called hypertension.
- Chronic kidney disease at stage 3a or higher.
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You have a BMI of 27 or higher and have at least one of these conditions:
- Prediabetes.
- A previous heart attack, also called myocardial infarction, or stroke.
- Blocked arteries in your legs or arms, also called peripheral artery disease, with symptoms.
- Already get GLP-1 drugs covered through your Medicare Part D plan.
- Have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease. Your Part D plan may cover your GLP-1 medication for these conditions.
Provider Requirements
If you're eligible, your doctor or other healthcare provider must send a prescription for a covered GLP-1 drug to the pharmacy and, when requested, complete a prior authorization.
Your provider must certify that you're using the GLP-1 drug as part of a lifestyle program that focuses on diet and exercise.
Your pharmacy may ask for your Medicare Number or the last four digits of your Social Security Number to help process your prescription.
You'll receive a letter in the mail confirming that your GLP-1 drug is covered under the Medicare GLP-1 Bridge.
Your prior authorization, including refills and dose changes, is valid through December 31, 2027, unless you change GLP-1 medications.
Frequently Asked Questions
Quick answers about eligibility, covered medications, costs, and how to use the Medicare GLP-1 Bridge program.
What is Medicare GLP-1 Bridge?
Medicare GLP-1 Bridge is a program beginning July 1, 2026, that helps eligible Medicare beneficiaries obtain certain GLP-1 weight-loss medications for $50 per month.
Which GLP-1 medications are covered?
The program covers:
- Foundayo® tablets
- Wegovy® injections or tablets
- Zepbound® KwikPen®
Single-dose Zepbound pens and Zepbound vials are not covered under this program.
How much will the medication cost?
Eligible participants pay $50 for a one-month supply, regardless of income.
The $50 payment does not count toward the Medicare drug plan deductible or yearly out-of-pocket limit.
Do I need Medicare Part D?
Yes. You must have Medicare Part D through either a standalone prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage.
Can I qualify if my Part D plan already covers a GLP-1 medication?
No. If your Medicare drug plan already covers your GLP-1 medication, you must continue receiving it through that plan.
Who may qualify for the program?
You must be at least 18, have qualifying Medicare Part D coverage, and meet one of the program’s BMI and medical condition requirements.
Examples include a BMI of 35 or higher, or a lower qualifying BMI combined with certain heart, kidney, blood pressure, or cardiovascular conditions.
Who is not eligible?
You generally are not eligible if you already receive a GLP-1 through your Part D plan or if you have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease.
Your regular Part D plan may already cover a GLP-1 medication for one of these conditions.
How do I apply for coverage?
Start by speaking with your doctor. If the medication is appropriate, your doctor will send the prescription to the pharmacy.
After your eligibility is confirmed, your doctor may need to submit a form or prior authorization to Medicare.
What information will the pharmacy need?
The pharmacy may request your Medicare ID number. If you do not have your Medicare card, it may be able to locate your information using the last four digits of your Social Security number.
Will I need a new approval for every refill?
No. A new approval is generally not required for refills or dose changes as long as you continue using the same covered GLP-1 medication.
Can I use the Medicare Prescription Payment Plan?
No. Medications received through Medicare GLP-1 Bridge are not eligible for the Medicare Prescription Payment Plan.
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