The Medicare GLP-1 Bridge: $50 a month for weight-loss GLP-1s
Since July 1, 2026, people with Medicare Part D can get Wegovy, Zepbound KwikPen or Foundayo for weight management at $50 a month, until December 31, 2027.
The Medicare GLP-1 Bridge is a short-term demonstration run by CMS, not a Part D benefit. From July 1, 2026 to December 31, 2027 it gives Medicare Part D enrollees access to three weight-management drugs, Wegovy in every form, Zepbound in the KwikPen only and Foundayo, for a flat copay of $50 a month. To qualify, you must be enrolled in a standalone drug plan or a Medicare Advantage plan with drug coverage, be prescribed the drug to reduce and maintain body weight, and have had, when you started a GLP-1, a body-mass index of at least 35, or 30 with heart failure with preserved ejection fraction, uncontrolled hypertension or kidney disease stage 3a or worse, or 27 with prediabetes, a past heart attack or stroke, or peripheral artery disease. People whose GLP-1 is covered by Part D for diabetes, sleep apnea or MASH are excluded. The $50 does not count toward the $2,100 Part D cap and Extra Help does not reduce it.
What the $50 Bridge saves you
Saving over 18 months
$5,382
| Self-pay, 2.4 mg | $349 a month |
| Bridge copay | $50 a month |
| Bridge window | Jul 2026 to Dec 2027 (18 months) |
Prior authorization and BMI criteria apply. Estimate only.
Prices read by Radif Partners · Editorial policy · Method and data
Why a bridge, and to what
Federal law excludes drugs used for weight loss from Part D, and the definition of a Part D drug in 42 CFR 423.100 repeats that exclusion. CMS designed the BALANCE Model to negotiate prices and coverage for these drugs in Medicaid and Medicare; the Medicare part was expected in January 2027. CMS announced that BALANCE will not launch in Part D in 2027 and extended the Bridge through December 31, 2027 instead. The Bridge sits outside Part D: a single central processor handles prior authorizations, claims and pharmacy payments, and your plan does not need to opt in.
What it costs, and what it saves
The copay is $50 for a month’s supply, whatever the strength. The Part D deductible does not apply, nothing counts toward your yearly out-of-pocket total, and the low-income subsidy does not lower it. Against the self-pay prices, the saving is large: $299 a month on Wegovy 2.4 mg, $399 on a 10 mg Zepbound KwikPen, $249 on Foundayo 9 mg. Over the eighteen months of the program a Wegovy patient keeps $5,382.
Which threshold applies to you
The criteria apply at the time you started GLP-1 therapy, which may be before you joined Medicare or before July 2026. CMS gives the example of someone who started at a BMI of 37 and weighs in at 34 today: the prescriber attests the starting value. The tool below computes a BMI from height and weight and shows which threshold the listed diagnoses set. It is arithmetic, not an eligibility decision: your prescriber attests under penalty of perjury, and CMS can check the attestation against Medicare data.
Which BMI threshold applies to you
Your BMI at the start
37.1
| Threshold that applies | ≥ 35 |
| Meets the BMI criterion | Yes |
CMS also excludes people whose GLP-1 is covered by Part D (diabetes, sleep apnea, MASH). Your prescriber attests; this is not medical advice.
How to get it
- Your prescriber sends a prior authorization to the Bridge’s central processor, by fax or electronic portal. CMS says decisions come within 72 hours and are mailed to you.
- The pharmacy fills the prescription and bills the Bridge, not your plan. You pay $50.
- Pen needles are not covered for the Zepbound KwikPen; buy them separately.
Who is left out
People in private fee-for-service plans, cost plans, PACE and a few other arrangements without a standalone drug plan are not eligible. Ozempic, Mounjaro and other diabetes GLP-1s are not Bridge drugs, nor are Zepbound vials and single-dose pens. If your GLP-1 is prescribed for type 2 diabetes, sleep apnea or MASH, your Part D plan covers it and the Bridge does not apply.