Medicare coverage of GLP-1s for obesity begins in July 2026 through the Medicare GLP-1 Bridge and will be extended through the end of 2027.
CMS will provide Part D beneficiaries with coverage of select GLP-1s for obesity from July 1, 2026, to December 31, 2027 (originally December 31, 2026) through the Medicare GLP-1 Bridge, a short-term demonstration established under Section 402 demonstration authority. The Medicare GLP-1 Bridge is a nationwide demonstration program that will be separate from Part D coverage, meaning Part D sponsors will not have to opt into the demonstration for eligible beneficiaries to gain access, nor will Part D sponsors bear any financial risk for costs incurred by their enrollees associated with the demonstration.
Medicare beneficiaries enrolled in Part D plans who meet the eligibility criteria will have access to GLP-1 medications approved for weight reduction (all formulations of both Foundayo and Wegovy and the KwikPen formulation of Zepbound) at a copayment of $50 per month. For a beneficiary to qualify, their provider must submit a prior authorization request that attests the beneficiary is being prescribed the drug to reduce excess body weight and ongoing maintenance of weight reduction and that they fall into one of three categories related to BMI and other clinical diagnostic criteria (Figure 3).