Jun 27, 2026
GLP-1 drugs, also called semaglutide (but better known by brand names like Ozempic, Wegovy and Zepbound), have exploded in popularity in recent years. Originally marketed as a treatment for Type 2 diabetes, they have also been used for weight loss — for those who can afford them.
“These medications are a breakthrough for clinically significant weight loss,” Kanwar Kelley, MD and chief executive officer of Side Health, told Healthline. “However, in my practice, there are individuals that simply cannot afford the cost of these medications, even when the insurance pays some of the cost.”
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Americans spend billions of dollars on GLP-1s per year. Without insurance, people can expect to pay between $900 to $1,400 per month, according to reporting in Forbes. But insurance companies are increasingly dropping GLP-1 coverage for weight loss, leaving people to either pay out-of-pocket or stop taking the drug entirely, NPR reports.
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A new Medicare Bridge program might change that for Americans on Medicare Part D. The temporary program would allow qualified patients to buy GLP-1s for just $50 per month — a significant price savings.
“The bridge program, if it reaches its goal, will provide a road for patients to get started on these medications and get the help they need,” Kelley said.
But not everyone who uses Medicare will qualify for the plan. Here’s what you need to do to qualify — and what to know before you start.
How to know if you qualify for the Medicare Bridge program
Medicare Part D has historically excluded drugs that are exclusively used for weight loss, as laid out in the 2003 Medicare Modernization Act.
The bridge program will cover four different GLP-1 drugs — two injectable types and two pill types — and will allow eligible Part D users to pay only $50 per month to use them.
You won’t get to apply the $50 co-pay toward your out-of-pocket maximum.
In order to be eligible, you need to have Medicare Part D. Most people have to be 65 to qualify for a Medicare Part D plan, but those with an eligible disability can get on the plan before that.
You’ll need to get prior authorization to be eligible for the plan. To successfully get prior authorization, you’ll need to fit one of the qualifying criteria:
- Have a body mass index (BMI) of at least 35;
- Have a BMI between 30 and 34.99, along with at least one of these conditions: diastolic heart failure, hypertension, chronic kidney disease at state 3a or higher, prediabetes, a history of heart attack or stroke, or blocked arteries in your legs and arms; or
- Have a BMI between 27 and 29.99, along with at least one of these conditions: prediabetes, a history of heart attack or stroke, or blocked arteries in your legs or arms with symptoms.
You’ll also need to be at least 18 years of age.
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If you already get GLP-1 drugs through your Part D plan — for example, to treat Type 2 diabetes or sleep apnea — you won’t be eligible for this program, even if your monthly copay is higher than $50.
Once you’re on the plan, you won’t need to get another prior authorization again as long as you stay on the same brand of medication.
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The program has an end date that could leave you on the hook
The major drawback to the bridge program is that it has a pre-defined end date of Dec. 31, 2027.
This leaves seniors who decide to use the program in a pickle. GLP-1s work best when they’re taken continuously. Some providers worry that quitting the drug could lead users to regain the weight they lost, and it could leave older GLP-1 users with less muscle mass than they had before, potentially putting them at risk of frailty.
“If it’s not renewed, you’re going to have all these patients on these meds, and then they’re going to stop them,” said John Batsis, a University of North Carolina School of Medicine obesity specialist. “Not only will weight come back, comorbidities will come back, and we know from lifestyle studies … when you gain it back, you’re gaining more fat than muscle.”
Like all drugs, GLP-1s have risks and benefits that you should talk over with your primary care provider. They can go over the risks with you, help you with overall medication management, and help you decide if a GLP-1 could help you meet your overall health goals.
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Kit Pulliam is a DC-based financial journalist with over five years of experience writing, editing, and fact-checking financial content.
