CMS adds Foundayo to the Medicare GLP-1 Bridge and clarifies that only the Zepbound KwikPen qualifies

The Centers for Medicare & Medicaid Services updated the list of drugs covered under the Medicare GLP-1 Bridge on April 6, 2026. The update adds all formulations of Foundayo (orforglipron) after its FDA approval, and clarifies that among Zepbound (tirzepatide) products, only the KwikPen is included ^[1].

The Bridge is a short-term CMS demonstration that gives eligible Medicare Part D beneficiaries access to certain GLP-1 drugs for weight management between July 1, 2026 and December 31, 2027 ^[1]. CMS says it extended the Bridge through the end of 2027 because the BALANCE Model is not launching in 2027, which also lets the agency collect more data on GLP-1 use to share with Part D plan sponsors ^[1].

What changed on the list

As of the April 6 update, an eligible GLP-1 drug under the Bridge — when used to reduce excess body weight and maintain weight reduction — is Foundayo, Wegovy (injection and tablets), or Zepbound KwikPen ^[1]. CMS spelled out that beginning July 1, 2026, all formulations of Foundayo, all formulations of Wegovy, and the KwikPen formulation of Zepbound will be available. "The single-dose vial and single-dose pen formulations of Zepbound® will not be available through the Medicare GLP-1 Bridge," the agency wrote ^[1].

CMS published the specific National Drug Codes: six for Foundayo (0002-4178-31, 0002-4503-31, 0002-4794-31, 0002-4803-31, 0002-4839-31, 0002-4953-31), ten for Wegovy, and six for Zepbound (0002-3566-11, 0002-3555-11, 0002-3544-11, 0002-3533-11, 0002-3522-11 and 0002-3511-11) ^[1]. The agency added that the list of products and NDCs may be updated over the course of the demonstration ^[1].

Foundayo, the oral GLP-1 orforglipron, was approved by FDA on April 1, 2026 to reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight plus at least one weight-related condition, in combination with a reduced-calorie diet and increased physical activity ^[2].

One related detail: pen needles for the Zepbound KwikPen are not covered by the Bridge and should not be billed to the Bridge or to a patient's Part D plan. CMS says patients can purchase pen needles separately ^[1].

Who the Bridge covers

The Bridge is limited to Part D beneficiaries in eligible plan types — a standalone prescription drug plan or a Medicare Advantage coordinated care plan with drug coverage (HMO, HMOPOS, and local and regional PPO) in CY 2026 ^[1]. Special Needs Plans, employer/union group waiver plans, and the LI NET program can participate; private fee-for-service plans, section 1876 cost contract plans, section 1833 health care prepayment plans, PACE organizations, fallback plans, and religious fraternal benefit plans cannot, unless the person is also enrolled in a standalone PDP ^[1].

A prescriber must submit a prior authorization attesting the patient is at least 18 and, at the time GLP-1 therapy was started, had a BMI of 35 or higher; or a BMI of 30 or higher with heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease stage 3a or above; or a BMI of 27 or higher with pre-diabetes, previous heart attack, previous stroke, or symptomatic peripheral artery disease ^[1]. Criteria must be met at the time therapy began, including for people who started before July 1, 2026 ^[1].

Drugs furnished through the Bridge carry a $50 co-pay and only when prescribed for weight management ^[1]. People whose GLP-1 is prescribed for type 2 diabetes, moderate to severe obstructive sleep apnea, or noncirrhotic MASH are supposed to get it through their Part D plan instead, because those indications are already Part D-covered ^[1].

Why it matters for patients

The formulation clarification is the practical part. Two people on the same molecule can land in different places: a tirzepatide prescription written for the Zepbound KwikPen is on the Bridge list, while the same drug dispensed as a single-dose pen or vial is not ^[1]. That may affect which device a pharmacy can bill under the demonstration starting July 1, 2026. CMS has not published a reason for the KwikPen-only limit, and the sources do not say whether the excluded formulations might be added later — only that the list may change ^[1].

Adding Foundayo means an oral option is on the list from the Bridge's first day ^[1][2]. The sources do not state Foundayo's price, launch date, or pharmacy availability.

What happens next

The Bridge starts July 1, 2026 and runs through December 31, 2027 ^[1]. Prescribers are told to send the prescription first and wait for the pharmacy to request prior authorization; submitting it earlier produces a "patient not found" error ^[1]. CMS runs a Bridge call center for prescribers at 855-273-0102, weekdays 8 a.m. to 7 p.m. ET ^[1].