Medicare GLP-1 Bridge Program
Medicare GLP-1 Bridge Program
A temporary federal program giving eligible Part D beneficiaries access to Wegovy, Zepbound KwikPen, and Foundayo for a $50 monthly copay — July 1, 2026 through December 31, 2027.
The Medicare GLP-1 Bridge Program is a temporary federal program from CMS that gives eligible Medicare Part D beneficiaries access to certain GLP-1 weight-management medications for a $50 monthly copay. It runs July 1, 2026 through December 31, 2027 and operates separately from your regular Part D drug benefit.
Who qualifies
You must meet both plan eligibility and clinical eligibility.
Plan eligibility
You must be enrolled in a standalone Medicare Part D Prescription Drug Plan (PDP) or a Medicare Advantage plan that includes drug coverage (MA-PD). SNPs, EGWPs, and dual-eligible beneficiaries also qualify if they meet clinical criteria.
Clinical eligibility — one of three pathways
- Age 18+ with a BMI of 35 or higher.
- Age 18+ with a BMI of 30 or higher and at least one of: heart failure with preserved ejection fraction; uncontrolled hypertension (systolic blood pressure above 140 mm Hg or diastolic above 90 mm Hg, despite treatment with two antihypertensive medications); or chronic kidney disease stage 3a or higher.
- Age 18+ with a BMI of 27+ and at least one of: pre-diabetes, prior heart attack, prior stroke, or symptomatic peripheral artery disease.
BMI is measured at the time therapy was started — if the medication has been working and your BMI is now lower, you can still qualify based on your starting BMI.
Covered medications (as of July 1, 2026)
- Foundayo — All formulations
- Wegovy — All formulations, including injection and tablets
- Zepbound — KwikPen formulation only — single-dose vial and single-dose pen are not included
CMS may update this list during the program. Verify current coverage at cms.gov.
What it costs
- $50 copay per monthly supply.
- The $50 copay does not count toward your Part D true out-of-pocket (TrOOP) costs.
- Extra Help / low-income subsidy does not reduce the $50 copay.
- Coupons and manufacturer discount programs may not be applied to Bridge claims.
How to access the program
Your doctor handles the prior authorization — not you and not your insurance agent.
- 1Talk to your doctor about whether you qualify. Bring up your weight, any related health conditions, and the medications listed above. Your doctor will know if you fit one of the clinical pathways.
- 2If you are already on a GLP-1, make sure your doctor has documentation of your height, weight, and BMI from the time you started therapy.
- 3Confirm you are enrolled in an eligible Medicare Part D or MA-PD plan.
- 4Your doctor submits the prior authorization and prescription to the CMS central processor.
When the Bridge does not apply
If your doctor is prescribing a GLP-1 for a condition already covered under standard Part D, the request goes through your Part D plan — not the Bridge. Examples:
- Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity
- Wegovy to reduce cardiovascular risk in adults with established cardiovascular disease and obesity or overweight
- Any GLP-1 prescribed for type 2 diabetes
In those cases, ask your prescriber to work through your Part D plan's normal prior authorization or formulary exception process.
Key dates
Program start
July 1, 2026
Program end
December 31, 2027
Questions about your drug coverage?
Not sure if your current plan makes you eligible for the Bridge? Fred can review your Part D coverage and walk you through the options.