What to know about Medicare’s new GLP-1 Bridge program

As effective as GLP-1 medications are for helping with weight loss, they usually come with one huge caveat: their price tag. These medications aren’t always covered by insurance, which means that, depending on your plan, the out-of-pocket prices can be higher than you’d like. 

But for some people, that might soon change. The Centers for Medicare & Medicaid Services is rolling out a new Medicare GLP-1 Bridge program, which allows qualified people on Medicare to get certain GLP-1s for just a $50 copay. Here’s what you need to know.

Medicare GLP-1 Bridge is a temporary program that starts July 1, 2026 and ends December 31, 2027. It provides select lower cost GLP-1 medications to eligible people enrolled in Medicare Part D (the part of Medicare that typically covers prescription medications). A note: Since many people may choose to stay on GLP-1s long-term to maintain their weight loss and other health benefits, Medicare is working on a permanent solution to have in place before the current December 2027 end date. 

Under this new program, certain GLP-1s approved for weight loss will be available for a $50 monthly copay. "This is more affordable than any cash-pay options for the newer generations of GLP-1s,” says Dr. Kerri Masutto, M.D., vice president of clinical and behavioral programs at Weight Watchers. “It’s a pleasant surprise that this is being offered, as the medications are now much more accessible for those on Medicare who meet the eligibility criteria.” Keep in mind that the $50 copays won’t count towards Part D deductibles or the $2,100 cap on out-of-pocket spending.

So what’s covered? The program includes the oral GLP-1 pill Foundayo ® (orforglipron), the injectable and oral forms of Wegovy ®, and the KwikPen® form of Zepbound ®. All doses of these medications are covered. If you take a GLP-1 for type 2 diabetes, such as Mounjaro or Ozempic, your Part D coverage is unchanged.

First, you have to be a Medicare Part D beneficiary. But beyond that, you also have to meet certain prior authorization criteria. This includes being 18 years or older and meeting one of the following criteria:

• A BMI of 35 or higher

• A BMI of 30 or higher if you also have a diagnosis of heart failure with preserved ejection fraction, uncontrolled hypertension while on at least two blood pressure medications, or chronic kidney disease stage 3a or above

• A BMI of 27 or higher if you have a diagnosis of pre-diabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease

Worth noting: The BMI qualification of 35 is higher than the threshold of having obesity (a BMI of 30). Because of that, the bridge won’t include everyone who meets the FDA definition of obesity, says Sarah Karlin-Smith, the research director for Public Citizen’s Access to Medicines Program. So if someone has, say, a BMI of 32 but are healthy, they wouldn’t be entitled for the program — even though they have obesity and could potentially benefit from it.

If you’re already taking a GLP-1 for weight loss and hope to get your medication under this new program, you may still qualify if you met the above criteria when you first started taking the medication. (In other words, if you’ve lost weight since starting your GLP-1, you can use your starting BMI to qualify for coverage.)

Although the Medicare GLP-1 Bridge program is designed for Medicare Part D members, it’s processed totally separately from Part D. Here’s how to participate in the program:

If you are a Weight Watchers Med+ Member

This whole process can feel simpler through Weight Watchers Med+ *, since membership includes access to insurance coordinators who can help you navigate the steps. There’s no special paperwork to fill out, just message your provider on or after July 1, 2026 and let them know you’re on Medicare and want to check if you qualify.

The Bridge program also requires you to combine the GLP-1 with ongoing lifestyle changes, including nutrition and physical activity. This is another bonus of getting your GLP-1 through Weight Watchers Med+, since membership includes our behavioral support program, "making it really, really easy to fulfill the requirement of making lifestyle changes, all under one roof," says Massuto. You’ll also have access to obesity-trained clinicians, coaching, and a community of others going on the journey, helping you feel supported while maximizing the health benefits of taking a GLP-1.

If you’re not a Weight Watchers Med+ Member

See your healthcare provider to find out if you’re eligible. If you are, your provider will submit a prior authorization request to the program along with a prescription for an eligible GLP-1 drug. After you’re approved, you can pick up the medication at the pharmacy with a $50 copay.

The Medicare GLP-1 Bridge program is a new, temporary way for people who meet certain criteria to get GLP-1 weight-loss medications for a $50 copay. This can allow more people to lose weight and improve their health with these medications. The eligibility doesn't extend to everyone who meets the FDA's definition of obesity, but ultimately, it’s a step in the right direction towards making these medications more accessible to people who would otherwise not be able to afford them.