Medicare Launches GLP-1 Bridge Program for Weight Loss Drugs
Medicare began covering GLP-1 weight loss medications on July 1 through a new Bridge Program that charges eligible beneficiaries a flat $50 monthly copay. The program covers Wegovy, Zepbound, and Foundayo for patients who meet specific BMI and health criteria.
Medicare started covering GLP-1 weight loss medications on July 1, 2026, through a new demonstration program that gives eligible beneficiaries access to three drugs for a flat $50 monthly copayment.
The Centers for Medicare and Medicaid Services launched the GLP-1 Bridge Program as a temporary measure running through December 31, 2027. Standard Medicare Part D plans are prohibited by federal law from covering drugs prescribed specifically for weight loss, so CMS set up the Bridge Program outside the normal Part D payment system.
The program covers three medications: Wegovy injections and tablets, Zepbound KwikPen, and Foundayo tablets. To qualify, a beneficiary must be 18 or older, enrolled in a Medicare Part D plan, and meet body mass index requirements. Patients with a BMI of 35 or higher qualify outright. Those with a BMI between 30 and 34.99 must have at least one qualifying condition, such as heart failure, uncontrolled hypertension, chronic kidney disease, prediabetes, or a history of heart attack or stroke.
The $50 copay does not count toward annual deductibles or out-of-pocket maximums and cannot be reduced by the Extra Help low-income subsidy program. Providers must submit a prescription and, when requested, a prior authorization form confirming the patient is participating in a diet and exercise program.
The Bridge Program is separate from the BALANCE model, a broader proposal to add weight loss drug coverage to standard Part D benefits. That initiative has been delayed indefinitely.
Health advocates say the program is a meaningful step for the millions of Medicare beneficiaries who have been unable to afford GLP-1 medications, which can cost more than $1,000 per month without coverage.
