Medicare · Coverage
Medicare coverage for GLP-1 drugs: the $50 a month Bridge program
Last reviewed October 12, 20268 min readBy the Goodsurance editorial team Reviewed by the Goodsurance editorial team
Looking for Medicare coverage for GLP-1 drugs? The Medicare GLP-1 Bridge program gives some people on Medicare certain weight loss drugs for $50 a month. Here are the details: who qualifies, which drugs it covers, what it costs, and how to get it.
The short version
If you only read one part of this page, read this.
The short version
$50 for a one-month supply
You pay the same $50 no matter your income. It runs July 1, 2026 to December 31, 2027.
Three drugs only
Foundayo, Wegovy, and Zepbound (KwikPen only). Ozempic is not on the list.
You need Part D and a weight rule
You must be 18 or older, have Medicare drug coverage, and meet a BMI rule.
It is separate from your drug plan
The $50 does not count toward your Part D deductible or yearly limit. Extra Help cannot lower it.
What the Medicare GLP-1 Bridge is
The Medicare GLP-1 Bridge is a short-term program run by CMS, the agency that runs Medicare. It helps people with Medicare drug coverage (Part D) pay for certain GLP-1 drugs used to lose weight or keep weight off.
It started on July 1, 2026. It ends on December 31, 2027. It works in every state and U.S. territory.
The Bridge sits outside your regular drug plan. Medicare pays the pharmacy through its own system. Your drug plan does not have to sign up for you to use it.
| Bridge detail | What CMS says |
|---|---|
| What you pay | $50 for a one-month supply (28 or 30 days) |
| Drugs covered | Foundayo (tablet), Wegovy (shot or tablet), Zepbound (KwikPen only) |
| Start date | July 1, 2026 |
| End date | December 31, 2027 |
| Where | Nationwide, including all states and U.S. territories |
| Part D deductible applies | No |
| Counts toward your yearly Part D limit | No |
| Extra Help lowers the $50 | No |
| Can use the Prescription Payment Plan | No |
Sources: CMS, "Medicare GLP-1 Bridge," and Medicare.gov, "Weight loss drugs." Checked October 12, 2026.
Who qualifies for the GLP-1 Bridge
Medicare lists four rules. You must meet all four.
Your doctor must also say that you are using the drug along with a diet and exercise plan.
You must meet all four rules
1. You have Medicare drug coverage (Part D)
A stand-alone drug plan, or a Medicare Advantage plan with drug coverage. Private Fee-for-Service, cost plans, and PACE do not count unless you also have a stand-alone drug plan.
2. Your drug plan does not already cover a GLP-1 for you
If your plan pays for a GLP-1 for you now, for any reason, you keep getting it through your plan.
3. You do not have type 2 diabetes, sleep apnea, or fatty liver disease
Sleep apnea here means moderate to severe. With any of these, ask your drug plan. It may cover a GLP-1 for you.
4. You are 18 or older and meet a BMI rule
BMI is a number from your height and weight. It is checked when you start the drug. See the table below.
| Your BMI | You also need |
|---|---|
| 35 or higher | Nothing else. BMI alone is enough. |
| 30 or higher | One of these: a type of heart failure (HFpEF), high blood pressure that is hard to control, or kidney disease at stage 3a or higher |
| 27 or higher | One of these: prediabetes, a past heart attack or stroke, or blocked arteries in the legs or arms with symptoms |
You must also be 18 or older. Source: Medicare.gov, "Weight loss drugs," and CMS fact sheet 12234.
Which drugs the Bridge covers
The Bridge covers three drugs: Foundayo (a tablet), Wegovy (a shot or a tablet), and Zepbound in the KwikPen only.
Ozempic is not on the list. Neither are Zepbound single-dose pens or vials. If your doctor prescribes one of those, the Bridge will not pay for it.
Which drugs the Bridge covers
Covered
- Foundayo (tablet)
- Wegovy (shot or tablet)
- Zepbound KwikPen
Not covered by the Bridge
- Zepbound single-dose pens and vials
- Ozempic and every other GLP-1 not listed
- Pen needles
Source: Medicare.gov, "Weight loss drugs," and CMS, "Information for Providers."
What it costs
You pay $50 for a one-month supply. That is 28 or 30 days, based on the drug. The price is the same no matter your income.
There is no deductible to meet first. But the $50 is kept apart from your drug plan in four ways:
- It does not count toward your Part D deductible or your yearly out-of-pocket limit.
- It does not show on your Part D Explanation of Benefits or your Medicare Summary Notice.
- Extra Help cannot lower it.
- You cannot spread it out with the Medicare Prescription Payment Plan.
How to get a GLP-1 drug through the Bridge
- Talk to your doctor. Ask if a GLP-1 drug is right for you and if you qualify.
- Your doctor sends a prescription to your pharmacy.
- The pharmacy may call you. It needs your Medicare Number. If you do not have your card, it can look you up with the last four digits of your Social Security number.
- Your doctor sends a form to get approval from Medicare. This is called prior authorization.
- You get a letter from Medicare that says your drug is covered.
- Pick up your drug and pay $50 for a one-month supply.
For refills, you do not need a new approval if you stay on the same drug, even if your dose changes. Your approval lasts through December 31, 2027. If you switch to a different GLP-1, your doctor needs a new approval.
Not sure you qualify? Medicare.gov has a short eligibility check. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
How to get a Bridge drug
Source: CMS fact sheet 12234, "Medicare GLP-1 Bridge: GLP-1 Drugs for $50 a Month."
Weight loss vs. diabetes: two different paths
The same kind of drug can be covered in two ways. It depends on why you take it.
For weight loss, the Bridge is the path. You pay $50 a month if you meet the rules.
For type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease, your Part D plan is the path. Your plan may cover a GLP-1 for you under its normal rules and costs. The same goes if your doctor prescribes the drug to lower your risk of heart attack or stroke. Those prescriptions go to your plan, not the Bridge.
If your plan already pays for a GLP-1 for you, keep getting it through your plan. You cannot move it to the Bridge.
| Compare | GLP-1 Bridge | Your Part D plan |
|---|---|---|
| Who it is for | Weight loss, if you meet the BMI rules | Type 2 diabetes, sleep apnea, fatty liver disease, or heart risk, if your plan covers it |
| Who runs it | Medicare, outside your drug plan | Your drug plan |
| What you pay | $50 a month | Your plan's own costs |
| Counts toward your deductible and yearly limit | ✗ | ✓ |
| Extra Help can lower the cost | ✗ | ✓ |
| Shows on your Explanation of Benefits | ✗ | ✓ |
Sources: Medicare.gov, "Weight loss drugs" and "Help with drug costs"; CMS, "Information for Providers."
When the Bridge starts and ends
The Bridge runs from July 1, 2026 through December 31, 2027. CMS first planned a bigger program, called BALANCE, to follow it. CMS extended the Bridge through 2027 because BALANCE will not start in Medicare in 2027.
As of October 2026, CMS has not said what will happen after December 31, 2027. If you start a Bridge drug, plan with your doctor for that date.
Open Enrollment for 2027 drug plans runs October 15 to December 7, 2026. If you change plans, make sure your new plan still includes Medicare drug coverage. You need it to stay in the Bridge. See why your Part D premium may change in 2027.
When the Bridge runs
After December 31, 2027, the Bridge ends. As of October 2026, CMS has not said what comes next.
What the Bridge does not cover
The Bridge is narrow on purpose. It covers three drugs, for one use, for a set time.
If you are turned down, there is no appeals process. Your doctor can send the form again with corrected or new facts.
What the Bridge does and does not do
It does
- Cover three weight loss drugs for $50 a month
- Keep your approval through December 31, 2027, with refills and dose changes
- Work in every state and U.S. territory
It does not
- Count the $50 toward your Part D deductible or yearly limit
- Let Extra Help lower the $50
- Let you spread the $50 out with the Prescription Payment Plan
- Cover GLP-1s for type 2 diabetes, sleep apnea, or fatty liver disease
- Have an appeals process if you are turned down
Sources: Medicare.gov, "Weight loss drugs"; CMS, "Information for Providers."
How the Bridge fits with Part D and Extra Help
You need Medicare Part D to use the Bridge. That can be a stand-alone drug plan or a Medicare Advantage plan with drug coverage. Special Needs Plans, employer or union retiree plans, and the LI NET program count too.
Extra Help lowers what you pay for Part D drugs. People with Extra Help can use the Bridge. But Extra Help does not lower the $50 Bridge copay. People with both Medicare and Medicaid can use the Bridge if their plan type is on the list.
If you do not qualify for the Bridge, Medicare.gov lists other ways to save. These include drug company help programs, state drug programs, and mail order pharmacies. Medicare.gov also points to TrumpRx.gov for cash price coupons. Coupons like these are not drug coverage. They do not count toward your deductible or yearly limit.
For free, one-on-one help, contact your State Health Insurance Assistance Program (SHIP).
Common questions about Medicare
Quick answers, fast .
Tap any question to expand. Each links to a fuller standalone answer.
What is the Medicare GLP-1 Bridge?
It is a short-term Medicare program. People with Part D who qualify can get certain GLP-1 weight loss drugs for $50 a month. It runs from July 1, 2026 through December 31, 2027.
How do I know if I qualify?
You must have Medicare drug coverage, be 18 or older, and meet a BMI rule. Your drug plan must not already cover a GLP-1 for you. You must not have type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease. Use the eligibility check on Medicare.gov/glp1bridge, then ask your doctor.
How much does the GLP-1 Bridge cost?
You pay $50 for a one-month supply at the pharmacy. The price is the same for everyone, no matter your income. There is no deductible first.
Does the $50 count toward my Part D out-of-pocket limit?
No. The $50 does not count toward your Part D deductible or your yearly out-of-pocket limit. It also does not show on your Part D Explanation of Benefits.
What is Extra Help, and does it lower the $50?
Extra Help is a Medicare program that lowers Part D drug costs for people with limited income and savings. It does not lower the $50 Bridge copay. You still pay $50 a month.
Does the Bridge cover Ozempic?
No. The Bridge covers only Foundayo, Wegovy, and Zepbound KwikPen. If you take Ozempic for type 2 diabetes, your Part D plan may cover it under its own rules.
Can I use the Bridge if I have Medicare Advantage?
Yes, if your Medicare Advantage plan includes drug coverage. HMO, HMO-POS, and PPO plans count, and so do Special Needs Plans. Private Fee-for-Service plans, cost plans, and PACE do not, unless you also have a stand-alone drug plan.
How long does the program last?
The Bridge runs through December 31, 2027. Your approval lasts until then, as long as you stay on the same drug. How long you take a GLP-1 is a choice to make with your doctor.
What happens after December 2027?
The Bridge ends on December 31, 2027. As of October 2026, CMS has not said what comes next. Talk with your doctor about a plan for that date.
What if Medicare does not approve my request?
There is no appeals process for the Bridge. Your doctor can send the form again if something was wrong or if there are new facts. For questions, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Where can I get GLP-1 drugs for weight loss?
If you qualify for the Bridge, you get them at your pharmacy with a prescription and pay $50 a month. If you do not qualify, Medicare.gov lists drug company help programs, state programs, and mail order pharmacies.
I have type 2 diabetes. Can I get a GLP-1?
Not through the Bridge. But your Part D plan may cover a GLP-1 for diabetes under its normal rules. Call your plan or check its drug list.
References
- Medicare.gov: Weight loss drugs (Medicare GLP-1 Bridge)Drugs, eligibility, steps, and cost rules. Also at Medicare.gov/glp1bridge.
- CMS: Medicare GLP-1 BridgeProgram dates, $50 copay, deductible and out-of-pocket rules, Extra Help (LIS).
- CMS: Medicare GLP-1 Bridge, Information for ProvidersClinical criteria, exclusions, plan types, prior authorization, no appeals process.
- CMS fact sheet 12234: Medicare GLP-1 Bridge, GLP-1 Drugs for $50 a MonthThe four eligibility rules and how to get the drugs. June 2026.
- CMS fact sheet 12229: Your Medicare in 2027, What's New & ChangingConfirms the $50 copay for a one-month supply. September 2026.
- CMS press release: CMS Launches Medicare GLP-1 BridgeJuly 1, 2026 launch; available through December 31, 2027.
- CMS Innovation Center: BALANCE ModelWhy the Bridge was extended through 2027.
- Medicare.gov: Help with drug costs (Extra Help)Who can get Extra Help and how to apply.
- Medicare.gov: Medicare Prescription Payment PlanHow the payment plan works for Part D drugs.
- NIH: Calculate your BMIA BMI calculator from the National Heart, Lung, and Blood Institute.
- SHIP: State Health Insurance Assistance ProgramFree, unbiased Medicare counseling in every state.