The Centers for Medicare and Medicaid (CMS) began a short-term demonstration, called the Medicare GLP-1 Bridge, that expands access to GLP-1 weight-loss medication under the Medicare Part D programs. Eligible Medicare beneficiaries can now access certain GLP-1 Medications for just a $50 copay. The Bridge demonstration lasts for a period of 18 months, from July 1, 2026 to December 31, 2027. Current beneficiaries should see if they’re eligible by checking CMS guidelines
Here’s What You Need to Know
- The Medicare Bridge Demonstration began July 1, 2026 and goes until December 31, 2027.
- Eligible Medicare beneficiaries will be able to access certain GLP-1 Medications for $50. The $50 copay will not count toward the Part D deductible, nor does it count towards the annual $2,100 out-of-pocket cap on prescription drug costs.
- The $50 copay is only for weight loss. If you already take a GLP-1 for Type 2 diabetes, cardiovascular disease, or sleep apnea, you’ll continue to access your medication through your Part D plan.
- In order to access these medications, you must be enrolled in a Medicare Part D plan, which covers prescription drugs. You also must have a body mass index (BMI) of 27 and have a comorbid condition, or a BMI of 35 or higher.
- The demonstration provides coverage for the injectable formulations of Wegovy, the KwikiPen formulation of Zepbound, and the Foundayo pill.
- The prescription process under the Bridge Demonstration is slightly unusual. Instead of going through your Part D plan, you will need prior authorization. Your doctor will send the prescription to a central system. Once approved, you will be able to pick up your prescription for $50 at your pharmacy.
- Doctors do not need to be enrolled Medicare providers to write a prescription or submit a prior authorization request.
