Medicare GLP-1 Bridge Program: What You Need to Know
Medicare recently launched a new pilot program called the Medicare GLP-1 Bridge. Running through December 31, 2027, it helps eligible Medicare clients pay as little as $50 per month for certain GLP-1 medications used for weight management — a significant savings for those who qualify. Not everyone with Medicare will meet the requirements, so read on to see where you stand and what to do next.
Program Overview
The Medicare GLP-1 Bridge covers three prescription medications:
Foundayo (Tablet)
Wegovy (Injection or Tablet)
Zepbound KwikPen (Injection only — single-dose pens and vials are NOT covered)
For those who qualify, the program offers meaningful savings on medications that can otherwise cost over $1,000 per month.
Who's Eligible?
You have Medicare Part D drug coverage (through a stand-alone Medicare drug plan or a Medicare health plan that includes drug coverage)
You are not currently eligible to receive a GLP-1 drug through your Medicare drug plan
You are at least 18 years old, and at least one of the following is true:
Your BMI* is 35 or higher
Your BMI* is 30 or higher, and you have certain types of heart failure, high blood pressure that's hard to control, or chronic kidney disease (stage 3a or above)
Your BMI* is 27 or higher, and you have prediabetes or have had a heart attack, stroke, or blocked arteries in your legs or arms
*BMI = Body Mass Index. Ask your doctor if you're not sure how yours is calculated.
Who's Not Eligible for the Bridge Program?
You have Type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease (you may already have GLP-1 coverage through your plan — contact them directly)
You don't meet the Part D, age, or BMI criteria above
Getting Started
Ready to find out if you qualify? Visit Medicare.gov for full program details, or follow these steps:
Determine if you qualify — review the eligibility checklist above, or contact Paul with any questions.
Contact your doctor to confirm you qualify.
Your doctor will submit a prescription and then will complete a prior authorization.
You'll get a letter in the mail confirming that your medication is covered by the GLP-1 Medicare Bridge program.
The process is designed to be simple on your end once your doctor confirms that you qualify.
Have questions before you talk to your doctor? Contact Paul Gunther at 206-890-0358 or pgunther@psbenefits.net — I'm happy to help you understand your options.
