The move is a noticeable shift for Medicare, which has historically denied coverage for GLP-1 medications for weight loss purposes. More than 66 million people in the U.S. get their health coverage from Medicare. Seniors and other qualifying Medicare recipients have largely been limited to GLP-1 drugs to treat health conditions like diabetes or cardiovascular disease. (3)
The 18-month program will run from July 1 until the end of next year, and will enable CMS to collect more data on the utilization of weight-loss drugs to share with Medicare plan providers. The goal is to roll out a permanent marketplace offering in 2028, BALANCE. (4)
How GLP-1 Medicare Bridge works
In order to access weight loss medications through GLP-1 Bridge, you must be enrolled in a Medicare Part D plan, which covers prescription drugs. Though, you will still need prior authorization from your doctor in order to receive treatment.
The good news is your doctor doesn't need to be listed as a Medicare provider to write a prescription or submit prior authorization to Humana, the plan administrator, on your behalf.
Eligibility will largely be determined by your body mass index. (5) If it's 27 or higher, you'll likely qualify. This is also true if you have a condition such as heart disease or prediabetes. Once you're approved, you'll pay $50 at the pharmacy.
At launch, the program will offer both the pill and injectible forms of Wegovy, Zepbound's KwikPen and the Foundayo pill.
Bridging the financial gap
A November 2025 KFF survey found that one in eight adults take GLP-1 drugs such as Wegovy or Ozempic for weight loss or to treat a health condition like diabetes. In the same study, however, respondents said the costs for the drugs were too high. (6)
In fact, weight loss medications can cost more than $1,000 without insurance. (7) Even with coupons or patient assistance programs, they can still cost between $149 to $299 for initial doses. (8)
A $50 copay at your local pharmacy through the GLP-1 Bridge program is substantially better than that. And yet, some working class families may not be able to afford the monthly expense in a world with sticky inflation and rising gas and food prices.
