The GLP-1 Bridge Program is a time-limited program that will provide eligible Medicare beneficiaries with access to certain GLP-1 drugs outside of the Part D benefit for weight loss. This program started July 1, 2026 and will run through December 31, 2027.
By law, Medicare cannot cover medications for weight loss. It would require a change to the law for weight loss medications to be covered under the Part D benefit. This demonstration program allows Medicare to gather evidence/information to determine whether to pursue a change in the law.
Only certain GLP-1 medications will be part of the program. Medications covered:
- Wegovy (both injections and tablets)
- Zepbound (KwikPen)
- Foundayo
Eligibility for the program will require that beneficiaries:
- Be 18 or older
- Need the GLP-1 medication for weight loss and keeping weight off, meaning a person must meet one of these weight and health criteria to be eligible:
- BMI of 35 or higher
- BMI of 30 or higher and have certain health conditions, such as: Heart failure, Uncontrolled hypertension, Chronic kidney disease
- BMI of 27 or higher and have other health risks, such as: Pre-diabetes, Heart attack, Peripheral, Peripheral Artery Disease
- Have Medicare with prescription drug coverage either through a standalone Part D plan or a Medicare Advantage plan that includes drug coverage
- Have prior authorization/approval from the Bridge Program
The cost of each medication will be a fixed $50 monthly copay. This $50 does NOT count toward the deductible or the maximum out of pocket (TrOOP) limit. The Extra Help program cannot be used to lower the copayment.
More information will be coming out as the launch of this program gets closer. A list of questions/answers can be found at:
If this creates more questions for you, please reach out to Missouri SHIP to talk it through with a counselor. You can easily reach a SHIP counselor by calling Missouri SHIP at 1-800-390-3330.