Information & advocacy — not medical advice. We don't sell the drug; we help you afford it. Figures current as of June 2026.
The Medicare GLP-1 Bridge, explained
A temporary federal demonstration (the "Medicare GLP-1 Bridge", July 1, 2026 – December 31, 2027) that, for the first time, gives eligible Medicare Part D members access to certain GLP-1s for weight loss — at a flat $50/mo copay. CMS runs it directly, outside the normal Part D benefit, so your plan does not have to opt in.
Cost$50/mo flat copay — the Part D deductible does NOT apply
Who qualifies18 or older, on Part D, and BMI 35+ — or BMI 30+ / 27+ with a listed condition
Do you qualify?
You must be 18 or older, have Medicare drug coverage, and meet one of
these three tests when you start GLP-1 therapy:
BMI 35 or higher — on its own - no additional condition needed
BMI 30 or higher — plus at least one of: diastolic heart failure (heart failure with preserved ejection fraction), uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher
BMI 27 or higher — plus at least one of: prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease (blocked arteries in the legs or arms)
Check your own case
Nothing you type here leaves your browser. This checks the programme's published
criteria only - it is not medical advice and it is not a coverage decision.
You are NOT eligible if:
You already get GLP-1 drugs covered through your Medicare Part D plan.
You have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease - but your ordinary Part D plan might cover a GLP-1 for those, which is a separate path.
Which plans count: A stand-alone Medicare drug plan (PDP); a Medicare Advantage coordinated-care plan with drug coverage (MA-PD, including HMO, HMOPOS and Local/Regional PPO); a Special Needs Plan (SNP); an Employer/union group waiver plan (EGWP); or the Limited Income Newly Eligible Transition (LI NET) program. Nationwide, including all U.S. territories.
Which drugs
ONLY three products qualify: Foundayo (tablet), Wegovy (both the injection and the tablets), and the Zepbound KwikPen. Zepbound single-dose VIALS and single-dose pens are NOT included — the ~$299/mo self-pay vials do not qualify. Ozempic and Mounjaro are NOT eligible either (they're diabetes drugs; ordinary Part D coverage for diabetes is a separate, existing path).
The paperwork — there IS a prior authorization
The catch — read this
What to do
Confirm you have Part D drug coverage (stand-alone Part D, or Medicare Advantage with drugs).
Check yourself against the three BMI tests above — that is the whole eligibility question, and it is the one thing your plan cannot answer for you.
Ask your clinician to write the prescription for a Bridge-eligible product — Foundayo (tablet), Wegovy (injection or tablet), or the Zepbound KwikPen (not Zepbound vials) — to complete the prior authorization when the pharmacy requests it, and to certify that you are using the drug alongside a diet-and-exercise programme.