Medicare's GLP-1 Bridge begins, offering Foundayo, Wegovy and Zepbound for $50 a month

Medicare's GLP-1 Bridge began July 1, 2026, giving eligible Medicare Part D beneficiaries access to certain GLP-1 drugs for a flat $50 monthly copay through December 31, 2027 ^[1][2]. CMS calls it a short-term demonstration that runs outside the Part D benefit's normal coverage and payment flow ^[2][3].

The program covers Foundayo (orforglipron) tablets, Wegovy (semaglutide) as an injection or a tablet, and Zepbound (tirzepatide) in the KwikPen only ^[1][3][4]. The single-dose vial and single-dose pen versions of Zepbound are not covered, and CMS says the product list may change during the program ^[3][4].

Medicare.gov now publishes the numbers behind eligibility ^[1]. A beneficiary must be 18 or older and meet one of these, measured at the time GLP-1 therapy began ^[1][3]:

• BMI of 35 or higher
• BMI of 30 or higher, plus diastolic heart failure (heart failure with preserved ejection fraction), uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher
• BMI of 27 or higher, plus prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease

CMS defines uncontrolled hypertension as systolic blood pressure above 140 mm Hg or diastolic above 90 mm Hg despite treatment with two blood pressure medicines ^[3]. Because the test is applied at the start of therapy, someone who began a GLP-1 at a higher BMI and has since lost weight can still qualify; CMS gives the example of a BMI of 37 in September 2024 and 34 in July 2026 ^[3].

Two groups cannot use the program. People already receiving a GLP-1 covered by their Part D plan are excluded ^[1][4]. So are people with type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease, because CMS considers those conditions already eligible for Part D coverage and says those patients should keep filling through their plan ^[1][3].

The $50 copay is the same at every dose rather than rising with dose, and no part of it counts toward the Part D deductible or the $2,100 annual cap on out-of-pocket drug costs ^[2][5]. There is no low-income subsidy for these drugs under Bridge, and beneficiaries can get one 28- or 30-day supply per fill, with no 60- or 90-day or partial fills ^[2][4]. Pen needles for the Zepbound KwikPen are not covered ^[3][4]. A provider must send the prescription to the pharmacy and complete a prior authorization certifying the patient meets the criteria and is using the drug alongside a diet and exercise program ^[1][3]. CMS says requests will be processed within 72 hours, and approvals last through December 31, 2027 unless the patient switches drugs ^[4][5]. Humana is the central processor ^[4][5].

There were more than 69 million Medicare beneficiaries as of about a week before launch, and CMS expects "several million" to use Bridge, said Chris Klomp, the agency's director of Medicare and deputy administrator, at the Aspen Ideas Festival ^[5]. Novo Nordisk and Eli Lilly estimate 15 million to 20 million older adults qualify for weight loss drugs ^[5].

Why it matters for patients

The $50 copay is far below typical cash prices. Novo's Wegovy injections cost $199 for a lower dose for the first two months under a limited-time offer and up to $399 at the highest dose; Lilly's Zepbound KwikPen and single-dose vials run $299 to $699 a month depending on dose; the Wegovy pill tops out at $299 and Foundayo at $349 ^[5]. A quarter of Medicare beneficiaries had income below $24,600 in 2024, according to KFF ^[5].

Because the copay sits outside the Part D benefit, it does not count toward the deductible or the annual out-of-pocket cap, meaning patients pay about $600 a year on top of their other drug costs, said Rachel Schmidt, a research professor at Georgetown University's McCourt School of Public Policy ^[2][5].

Coverage is scheduled to end after 2027. "It's good news that Medicare is rolling out this program, but it is temporary, so it's really not clear at this point what happens after the end of the 18-month program duration," said Juliette Cubanski, director of the Program on Medicare Policy at KFF. "Whether that coverage will continue in some other fashion, or whether people might lose access at that point" ^[5]. Making it permanent would require a change in federal law or agreement among private insurers to cover the drugs in Part D plans ^[5]. Providers also expect a bumpy start; Dr. Carolynn Francavilla Brown of the Obesity Medicine Association said patients should not expect to pick up medication immediately on July 1 and that clinics and pharmacies will likely be strained "for the next couple of months" ^[5].

What happens next

Bridge runs through December 31, 2027 ^[1][2]. CMS extended it to that date after the BALANCE Model did not launch in 2027 and says it will collect data on GLP-1 use to share with Part D plan sponsors ^[2][3]. Prior authorizations stay valid through the end of the program unless a patient changes drugs ^[1][4]. How many people have enrolled since July 1 has not been reported.