Temporary Medicare weight-management program
Medicare GLP-1 Bridge: $50 GLP-1 Drugs for Weight Loss
Certain adults with eligible Part D coverage can obtain selected weight-management GLP-1 drugs for a $50 copay per one-month supply from July 1, 2026, through December 31, 2027.
Quick answer: The Medicare GLP-1 Bridge is a temporary nationwide CMS program for certain adults with eligible Medicare Part D coverage. Approved beneficiaries pay $50 for a 28- or 30-day supply of a covered GLP-1 drug. The Bridge operates outside ordinary Part D payment rules.
Medicare GLP-1 Bridge at a Glance
$50 one-month supply
Eligible beneficiaries pay $50 for a 28- or 30-day supply, regardless of income.
Part D required
You must have an eligible standalone drug plan or Medicare health plan that includes Part D.
Temporary program
The Bridge runs from July 1, 2026, through December 31, 2027, under current CMS guidance.
The Bridge is not ordinary Part D formulary coverage. Its $50 payment does not satisfy the Part D deductible or count toward the annual out-of-pocket limit, and it cannot be placed in the Medicare Prescription Payment Plan.
Who May Qualify?
The provider must prescribe the drug for weight reduction and maintenance together with an ongoing lifestyle program, and the adult must meet a qualifying BMI and health-condition pathway when GLP-1 therapy began.
| BMI pathway | Additional listed condition |
|---|---|
| BMI of 35 or higher | No additional listed condition is required under this pathway. |
| BMI of 30 or higher | At least one listed condition, such as heart failure with preserved ejection fraction, qualifying uncontrolled hypertension or chronic kidney disease stage 3a or higher. |
| BMI of 27 or higher | At least one listed condition, such as prediabetes, prior heart attack, prior stroke or symptomatic peripheral artery disease. |
Official criteria are more detailed than this summary. The provider must use current Medicare instructions and attest to the required information.
Who Does Not Qualify for the Bridge?
Meeting a BMI pathway does not automatically make someone eligible. CMS also applies exclusions designed to keep ordinary Part D-covered GLP-1 treatment inside the Part D benefit instead of moving it into the Bridge.
Part D-coverable GLP-1 diagnosis
A beneficiary is not eligible for the Bridge when the provider attests to a condition for which GLP-1 treatment is currently coverable under Part D. CMS specifically identifies type 2 diabetes, moderate-to-severe obstructive sleep apnea, and noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced fibrosis among these exclusions.
GLP-1 received through Part D in 2026
A beneficiary who has received a GLP-1 through a Part D plan at any point during calendar year 2026 is not eligible for the Bridge, even if a later prescription is for weight management and the person otherwise meets the Bridge clinical criteria.
Bridge and Part D are separate coverage paths. If the GLP-1 is being used for a Medicare Part D-covered indication, the drug should be pursued through the beneficiary’s Part D plan and its formulary, prior-authorization or exception process rather than through the Bridge.
Which GLP-1 Drugs Are Included?
As of August 2026, Medicare lists the following products for qualifying Bridge use. The list may change during the temporary program.
| Drug | Bridge formulation | Important limitation |
|---|---|---|
| Foundayo® | Tablet | Must be prescribed for qualifying Bridge weight-management use. |
| Wegovy® | Injection or tablet | Ordinary Part D rules apply when prescribed for a Part D-covered indication. |
| Zepbound® | KwikPen® only | Single-dose vials and pens are not covered through the Bridge. |
Pen needles for the Zepbound KwikPen are purchased separately and are not covered by the Bridge.
How Do the Cost Rules Differ?
| Cost question | Bridge rule |
|---|---|
| Copay | $50 for a 28- or 30-day supply |
| Part D deductible | Does not apply to the Bridge fill |
| Part D out-of-pocket cap | The $50 does not count toward the 2026 $2,100 limit |
| Extra Help | Does not reduce the Bridge copay below $50 |
| Prescription Payment Plan | Bridge fills are not eligible |
| Extended supply | 60- and 90-day fills are not available through the Bridge |
See Part D costs in 2026 for the ordinary deductible and out-of-pocket rules.
How Does Someone Request Bridge Coverage?
- The medical provider decides whether a listed GLP-1 is appropriate and whether the person appears to meet the criteria.
- The provider prescribes the covered product for qualifying weight-management use.
- The pharmacy routes the claim through the Bridge process. The prescriber should generally wait for the pharmacy-generated prior-authorization request before submitting the authorization.
- The provider completes the required prior authorization with the clinical information.
- CMS generally communicates the prior-authorization approval or denial to the beneficiary and prescriber within 72 hours of submission.
- After approval, the beneficiary pays $50 for a one-month supply. The approval remains valid through December 31, 2027, and refills generally do not require a new prior authorization unless the beneficiary switches from one covered Bridge GLP-1 drug to another.
Approval can follow the beneficiary through the Bridge period: Once a covered product is approved, dose changes and refills generally do not require a new Bridge prior authorization. A switch to a different covered GLP-1 product does require a new authorization.
The Bridge does not provide a formal appeal process. If information was incorrect, incomplete or changed, the prescriber can submit the prior-authorization request again with corrected information.
Medicare GLP-1 Bridge Questions
Does the Bridge cover Ozempic or Mounjaro?
No. As of August 2026, Medicare lists Foundayo, Wegovy and the Zepbound KwikPen for qualifying Bridge use. Other GLP-1 drugs may be covered by Part D for Medicare-covered indications.
Can someone with Original Medicare qualify?
Yes, if the person also has an eligible standalone Part D plan and meets all other Bridge requirements.
Can someone with Medicare Advantage qualify?
Many Medicare Advantage plans that include Part D are eligible plan types, but certain less-common plan types are excluded. Check the current Medicare criteria.
Can I use the Bridge if I received a GLP-1 through Part D earlier in 2026?
No. Under current CMS rules, a beneficiary who received a GLP-1 through a Part D plan at any point during calendar year 2026 is not eligible for the Bridge, even if a later prescription is for weight management and the person otherwise meets the Bridge criteria.
What if I have diabetes, sleep apnea or MASH?
If the provider attests to a condition for which GLP-1 treatment is currently coverable under Part D—such as type 2 diabetes, moderate-to-severe obstructive sleep apnea or qualifying noncirrhotic MASH with fibrosis—the Bridge prior authorization will be denied and the GLP-1 should be pursued through the Part D plan when appropriate.
How long does Bridge prior authorization take?
CMS generally communicates the Bridge prior-authorization approval or denial within 72 hours of submission.
How long does a Bridge approval last?
Under current CMS guidance, an approval remains valid through December 31, 2027. Refills generally do not require another prior authorization unless the beneficiary switches to a different covered Bridge GLP-1 drug.
Does Extra Help lower the $50 copay?
No. The Bridge copay is $50 regardless of income, and the payment does not count toward ordinary Part D out-of-pocket spending.
Can a Bridge drug use the Prescription Payment Plan?
No. Bridge drugs are not eligible for Medicare Prescription Payment Plan billing.
Who decides whether I qualify?
The provider supplies the clinical information and Medicare administers the authorization. Thompson Medicare Brokerage does not make medical or eligibility decisions.
Independent Medicare guidance
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