GLP-1 Drugs can help you manage your weight and improve your health. Early research, as reported by the New York Times, suggests that these drugs might help people live longer by improving people’s metabolic health, by helping them to regulate insulin and blood sugar levels, and causing weight loss. Several studies show that they also benefit cardiovascular, liver and kidney health. (1)
A new $50/month Medicare program for GLP-1s launched July 1, 2026. The Medicare GLP-1 Bridge Program covers these FDA-approved weight loss medications: Foundayo tablet, Wegovy injection or tablet, and Zepbound KwikPen through December 31, 2027 with a flat $50 monthly copay for eligible beneficiaries for a 1-month supply.
This benefit is separate from Part D and is NOT administered by any Medicare plan.
Eligibility: You must have a Part D plan: either a stand-alone Medicare Drug Plan or through any type of Medicare Advantage Plan that includes drug coverage, including a Special Needs Plan for Medicaid or a Chronic Plan; Employer/Union Group Waver Plan; Limited Income Newly Eligible Transition (LI NET) Program.
You must be 18 or older with a body mass Index (BMI) of 35 or more.
OR a BMI of 30-34.99 & have one of these conditions: Diastolic heart failure, Uncontrolled high blood pressure (hypertension), Chronic kidney disease at stage 3a or higher.
OR a BMI of 27-29.99 and have at least one of these conditions: Prediabetes, previous heart attack or stroke, blocked arteries in your legs or arms (peripheral artery disease)
You aren’t eligible if you: 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 (but your Part D plan might cover your GLP-1s).
How to get GLP-1 Drugs through the Medicare GLP-1 Bridge Program:
If your doctor feels one of these drugs is right for you, your doctor will send a prescription to the pharmacy. The pharmacy might reach out to you for your Medicare ID number & will need to see your Medicare card to process the prescription. If you don’t have your card, it can be looked up with the last 4 numbers of your social security number.
After the pharmacy receives confirmation that you are eligible for the Medicare GLP-1 Bridge Program, your doctor will need to submit a form to get approval from Medicare. You will also receive a letter from Medicare letting you know your medication is covered.
Pick up the medication at the pharmacy and pay $50 for a one-month supply. Your refill is valid until December 31, 2027 & doesn’t need approval as long as you stay on the same drug, even if the dose changes.
PLEASE NOTE: Since a separate Medicare program covers these drugs (not your regular plan’s drug coverage), your $50 copayment DOES NOT count toward your $2100 maximum out-of-pocket in 2026 or the $2400 maximum out-of-pocket in 2027. It also will not appear on any Medicare Summary Notice (MSN), and can’t be lowered by programs like Extra Help, a Medicare program that helps people with limited income and resources pay Part D costs. The costs also can’t be spread over multiple months using the Medicare Prescription Payment Plan.
- nytimes.com/202606/29/well/glp-1-drigs-ozempic-longevity.html
- https://www.medicare.gov/coverage/weight-loss-drugs
- https://www.empirical.health/blog/medicare-glp1-bridge-prior-authorization-form/
- For Questions, Contact Medicare at 800-633-4227 (800-Medicare)
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