Medicare beneficiaries may have heard recent news about expanded access to certain GLP-1 medications used for weight management. Beginning July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) launched the Medicare GLP-1 Bridge, a temporary nationwide demonstration program designed to provide eligible people with Medicare prescription drug coverage access to certain medications at a more manageable cost.
GLP-1 medications are a group of prescription drugs that may help individuals manage body weight and improve certain health outcomes. These medications work in different ways, including helping people feel full longer and reducing appetite. Although GLP-1 medications have received significant public attention, they are not appropriate for everyone and should only be used under the guidance of a qualified health care provider.
The Medicare GLP-1 Bridge is available to certain individuals who are enrolled in Medicare Part D prescription drug coverage. This may include people with a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage.
Eligible participants may receive certain GLP-1 medications used for weight management for a $50 monthly copayment. Medications currently included in the program are Foundayo, Wegovy, and the KwikPen formulation of Zepbound. Not every formulation of these medications is included, and coverage is limited to the specific products identified by CMS.
It is important to understand that the Medicare GLP-1 Bridge is not available to every person with Medicare. Eligibility is based on specific medical criteria, including body mass index, known as BMI, and certain qualifying health conditions. A health care provider must determine whether a person meets the program’s requirements and submit the required prior authorization. Medicare beneficiaries cannot enroll in the program simply by requesting the medication at a pharmacy.
The program also operates separately from the regular Medicare Part D prescription drug benefit. This means the $50 monthly copayment does not count toward a person’s Part D deductible or annual out-of-pocket prescription drug limit. In addition, the Medicare Extra Help program does not reduce the $50 copayment under the GLP-1 Bridge.
Individuals who already take a GLP-1 medication for another covered medical condition, such as diabetes, may have prescription coverage through their regular Medicare Part D plan. The Medicare GLP-1 Bridge is a separate program focused on access to certain medications for weight management. Individuals should speak with their health care provider and review their current prescription drug coverage before making changes to any medication.
Because GLP-1 medications may cause side effects and may interact with other medications or health conditions, it is important for individuals to discuss the possible benefits and risks with their doctor or other qualified health care provider. These medications are generally intended to be part of a broader health and weight-management plan that may include nutrition, physical activity, and ongoing medical care.
Medicare beneficiaries who believe they may qualify should begin by speaking with their health care provider. The provider can review their health history, discuss whether a GLP-1 medication may be appropriate, and determine whether the individual meets the Medicare GLP-1 Bridge requirements.
For more information about the Medicare GLP-1 Bridge, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
For information, assistance, and guidance regarding Medicare and other long-term services and supports, contact NY Connects at 716-753-4582 or email CCNYC@chqgov.com or by visiting your nearest Office for Aging Services during normal business hours. Our specialists can help you explore local resources and connect you with the services that best meet your family's needs.
