How Medicare Beneficiaries Can Access GLP-1 Medications Through the Bridge Program

You've probably heard about GLP-1 medications — drugs like Wegovy and Zepbound that have shown major results for weight management. What you may not know: as of July 1, 2026, Medicare is now covering three of them for a flat $50 monthly copay, through a new temporary federal program called the Medicare GLP-1 Bridge.

Here's what it actually covers, who qualifies, and how to get started.

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At a glance

• Program dates: July 1, 2026 – December 31, 2027

• Your cost: $50 per monthly supply

• Covered drugs: Foundayo, Wegovy, Zepbound (KwikPen only)

• How it runs: Through your existing Medicare Part D or Medicare Advantage drug plan

• Who handles the paperwork: Your doctor — not you

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What the Bridge Program actually is

The Medicare GLP-1 Bridge Program is a temporary CMS program that gives eligible Part D beneficiaries access to certain GLP-1 weight-management drugs for a flat $50 monthly copay.

It runs separately from your regular Part D benefit — which means the $50 copay doesn't count toward your deductible or out-of-pocket limit. It also can't be reduced further by Extra Help or manufacturer coupons.

Which drugs are covered

As of July 1, 2026, three drugs are covered:

• Foundayo — all formulations

• Wegovy — all formulations, including injection and tablet

• Zepbound — KwikPen only (single-dose vials and pens are not covered)

CMS can update this list during the program, so it's worth confirming current coverage before you start.

Who qualifies

You need to meet two kinds of eligibility: your plan type and your clinical profile.

Plan eligibility

You need to be enrolled in a standalone Part D plan (PDP) or a Medicare Advantage plan with drug coverage (MA-PD). Special Needs Plans, employer group waiver plans, and dual-eligible beneficiaries can also qualify if they meet the clinical criteria below.

Clinical eligibility — you need to meet one of these three:

1. Age 18+, BMI of 35 or higher

2. Age 18+, BMI of 30 or higher, plus one of: heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher

3. Age 18+, BMI of 27 or higher, plus one of: prediabetes, a prior heart attack, a prior stroke, or symptomatic peripheral artery disease

> Already on a GLP-1? Your BMI is measured at the point you started therapy. If the medication is working and your BMI has already come down, you can still qualify based on where you started.

When the Bridge doesn't apply

Some GLP-1 prescriptions run through your regular Part D plan instead of the Bridge — for example:

• Zepbound prescribed for sleep apnea

• Wegovy prescribed for cardiovascular risk reduction

• Any GLP-1 prescribed for type 2 diabetes

In those cases, your doctor works through your plan's normal prior authorization process, not the Bridge.

How to get started

This is handled by your doctor — not you, and not your insurance agent.

1. Talk to your doctor about whether you meet one of the three clinical pathways above.

2. If you're already on a GLP-1, make sure your doctor has your height, weight, and BMI documented from when you started.

3. Confirm your Part D or MA-PD plan is active.

4. Your doctor submits the prior authorization and prescription directly to CMS.

Where a local Medicare agent can help

The plan-eligibility side of this — confirming your Part D or MA-PD plan qualifies, understanding how the $50 copay interacts with your existing drug coverage — is where an agent is useful. The clinical side is between you and your doctor.

Fred at Lakes Health Insurance works with Medicare beneficiaries throughout the Minneapolis–St. Paul area and can review your current Part D coverage to confirm whether you're set up correctly for the Bridge program. No cost, no pressure.

Call 763.292.9837 or visit the GLP-1 Bridge Program page for full details, including the prior authorization form your doctor will need.

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Program details are set by CMS and may change. Verify current information at medicare.gov or by calling Fred.