Medicare GLP-1 Bridge program offers weight-loss drugs with $50 copay

The Centers for Medicare & Medicaid Services (CMS) has launched the GLP-1 Bridge demonstration, a short-term program running from July 1, 2026, through December 31, 2027. This initiative provides a workaround for Medicare beneficiaries to access specific anti-obesity medications, as current law prevents Medicare from covering these drugs directly.

Eligible participants pay a flat $50 monthly copayment for covered products, which include Wegovy (semaglutide), Zepbound KwikPen (tirzepatide), and Foundayo (orforglipron) tablets. The program operates outside the standard Part D benefit, meaning pharmacy workflows must adapt to handle these claims differently to avoid rejections.

Eligibility is strictly based on body mass index (BMI) and specific health conditions. Applicants must be at least 18 years old and enrolled in an eligible Part D plan. Requirements include a BMI of 35 or higher, or a BMI of 30 or higher when accompanied by conditions such as heart failure, uncontrolled hypertension, or chronic kidney disease. A lower BMI of 27 may qualify for those with prediabetes.

Notably, individuals who already receive GLP-1 medications through standard Medicare Part D coverage for conditions like type 2 diabetes, obstructive sleep apnea, or fatty liver disease do not qualify for the Bridge program.