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Jul 8, 202637 views2 min read

Medicare GLP-1 Bridge Program Launches July 1 With 50 Dollar Monthly Copay

The Centers for Medicare and Medicaid Services launched the Medicare GLP-1 Bridge program on July 1, 2026, giving eligible Part D beneficiaries access to weight-loss medications for a fixed 50 dollar monthly copayment. The program runs through December 31, 2027, and covers three specific GLP-1 drugs.

Medicare GLP-1 Bridge Program Launches July 1 With 50 Dollar Monthly Copay
Source:CMS.gov

The Centers for Medicare and Medicaid Services launched the Medicare GLP-1 Bridge program on July 1, 2026. The program gives eligible Medicare Part D beneficiaries access to specific GLP-1 weight-loss medications for a fixed 50 dollar monthly copayment.

The program runs through December 31, 2027. It operates outside the standard Part D benefit structure, meaning Part D sponsors do not bear financial risk for these drugs and are not required to opt in.

Three medications are covered: Foundayo (tablet), Wegovy (injection or tablet), and Zepbound (KwikPen formulation only). Single-dose pens and vials of Zepbound are excluded.

To qualify, beneficiaries must be enrolled in a Medicare Part D plan and not currently receiving a GLP-1 drug through their plan for other covered conditions such as type 2 diabetes or cardiovascular disease. Clinical eligibility requires a BMI of 35 or higher, or a BMI of 30 or higher combined with conditions such as heart failure or uncontrolled high blood pressure, or a BMI of 27 or higher combined with prediabetes or a history of heart attack or stroke.

The 50 dollar monthly copayment does not count toward the annual Part D deductible or out-of-pocket maximums. Beneficiaries must obtain prior authorization through the Bridge Program, with a provider attesting to their eligibility.

CMS uses a single central processor to manage prior authorizations, claims, and pharmacy payments. The program was extended through 2027 after the indefinite delay of the BALANCE Model for Medicare Part D.

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