Medicare GLP-1 Bridge Eligibility Checker
The short answer: from July 1, 2026, Medicare covers certain GLP-1 weight-loss drugs through the Medicare GLP-1 Bridge at a flat $50 monthly copay — if your BMI and health conditions match the program rules and you are not already getting those drugs covered by your Part D plan. Answer a few questions below and this checker will tell you whether you appear to qualify, and why.
Independent guide · built from the official Medicare.gov and CMS descriptions of the Medicare GLP-1 Bridge (fact sheet publication 12234). Not medical or plan advice — confirm with your plan or 1-800-MEDICARE.
Step 1 — Your measurements
BMI decides which eligibility route applies. Nothing you type is sent anywhere — this runs in your browser.
Step 3 — Coverage and exclusions
Which drugs are covered
| Drug | Form covered | Your copay |
|---|---|---|
| Foundayo® | Tablet | $50 / month |
| Wegovy® | Injection or tablet | $50 / month |
| Zepbound® | KwikPen® only | $50 / month |
| Zepbound® single-dose | Not covered by this program | — |
Source: Medicare.gov, “Weight loss drugs”, and the Medicare GLP-1 Bridge fact sheet (publication 12234).
Medicare drug coverage types that qualify
The program is available nationwide (all states and U.S. territories) to people with Part D coverage, including:
- • A standalone Medicare drug plan (PDP)
- • A Medicare Advantage plan with drug coverage (MA-PD: HMO, HMO-POS, local or regional PPO)
- • A Medicare Special Needs Plan (SNP)
- • An employer or union group waiver plan (EGWP)
- • The Limited Income Newly Eligible Transition (LI NET) program
Frequently asked questions
How much is the Medicare GLP-1 Bridge copay?
$50 per month. The Part D deductible does not apply, the $50 does not count toward TrOOP, and there is no low-income subsidy for this program.
How long does the Medicare GLP-1 Bridge last?
It runs from July 1, 2026 through December 31, 2027. It was extended through 2027, and runs outside the normal Part D benefit payment flow.
What BMI do I need to qualify?
BMI 35 or higher qualifies on its own. BMI 30+ needs one listed condition (diastolic heart failure, uncontrolled hypertension, or chronic kidney disease stage 3a+). BMI 27+ needs one listed condition (prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease).
Can I get it if I have diabetes or sleep apnea?
You are not eligible for the Bridge program if you have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease — but your Part D plan itself may cover your GLP-1s. Ask your plan.
Does Medicare cover weight-loss drugs in 2026?
Standard Part D plans generally do not cover GLP-1s for weight loss alone. From July 1, 2026 the Medicare GLP-1 Bridge covers Foundayo®, Wegovy®, and Zepbound® KwikPen® for people who meet its eligibility criteria, at a $50 monthly copay.
Need help getting this covered?
Whether you qualify for the GLP-1 Bridge or your Part D plan has to cover it, the part that actually stalls people is paperwork — the prescription, the prior authorization, and the plan conversations. Tell us a little about your situation and we will point you to the right local options and help you work out what to ask your plan. It is free, and we are not a drug company or an insurance seller.
The rules in plain English
What it costs
A flat $50 per month. No Part D deductible applies, the $50 does not count toward your TrOOP, and there is no low-income subsidy for this program.
How long it runs
July 1, 2026 – December 31, 2027. It is a temporary CMS demonstration that runs outside the normal Part D benefit, and it is available nationwide.
What you need to do
Your provider sends the prescription and completes a prior authorization, and must certify you are on a diet-and-exercise lifestyle program.
Planning other care costs? Use our elder care cost calculator for in-home care, adult day care, assisted living and nursing home monthly costs.
Frequently asked questions
How much is the Medicare GLP-1 Bridge copay?
It is $50 per month. The Part D deductible does not apply to these drugs under this program, the $50 does not count toward your TrOOP costs, and there is no low-income subsidy (LIS) for the Bridge program. The $50 cannot be lowered by Extra Help, and it cannot be spread across months with the Medicare Prescription Payment Plan.
How long does the Medicare GLP-1 Bridge last?
It runs from July 1, 2026 through December 31, 2027. CMS extended it through 2027, and it operates outside the normal Part D benefit payment flow, so Part D plans do not have to opt in.
What BMI do I need to qualify for the Medicare GLP-1 Bridge?
A BMI of 35 or higher qualifies on its own. A BMI of 30 or higher needs at least one listed condition: diastolic heart failure, uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher. A BMI of 27 or higher needs at least one of: prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease.
Can I get the Medicare GLP-1 Bridge if I have type 2 diabetes or sleep apnea?
You are not eligible for the Bridge program if you have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease. That is because those conditions may already be covered through your Part D plan — ask your plan, because it may cover your GLP-1 drugs directly.
Which GLP-1 drugs does Medicare cover in 2026?
From July 1, 2026 the Medicare GLP-1 Bridge covers Foundayo (tablet), Wegovy (injection or tablet), and Zepbound KwikPen only. The program does not cover single-dose Zepbound vials or pens. Standard Part D plans generally do not cover GLP-1 drugs for weight loss alone.
Do I need prior authorization for the Medicare GLP-1 Bridge?
Yes. Your doctor or health care provider must send the prescription to the pharmacy and complete a prior authorization when requested. Your provider must also certify that you are using the GLP-1 drug as part of a lifestyle program focused on diet and exercise. The prior authorization stays valid through December 31, 2027, including refills and dose changes, unless you switch GLP-1 drugs.
Where these numbers come from
- Medicare.gov — “Weight loss drugs” (Medicare GLP-1 Bridge coverage, eligibility and copay)
- CMS.gov — “Medicare GLP-1 Bridge” (program dates, authority, and copay treatment)
- Medicare GLP-1 Bridge fact sheet, publication 12234 — “GLP-1 Drugs for $50 a Month”
Every figure on this page is taken from those sources. Where the program gives a fixed number we state it as fixed; we do not estimate or fill gaps.