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3h ago

Medicare Launches GLP-1 Bridge to Cover Weight-Loss Drugs

Medicare will administer approvals and payments outside Part D with a $50 monthly copay for eligible patients.

Finding that extra weight made it harder for her to do things she enjoyed like walking her dogs, Mary Abrahamson began using a compounded GLP-1 drug for weight loss two years ago.
Abrahamson now hopes she qualifies for Medicare's new Bridge program so she can access a weight-loss drug for only $50 a month.
Diane Lane-Cormier doesn't think she will qualify for Medicare's Bridge program, which she finds frustrating.
Deb Cooperman is unsure whether she will qualify for Medicare new coverage for weight-loss medications.

Overview

  • The Medicare GLP-1 Bridge, which begins on Wednesday, July 1, allows eligible Part D enrollees who meet BMI and clinical criteria to get approved obesity drugs for a $50 monthly copay.
  • Medicare will run the program directly rather than using private Part D plans, handling prior authorizations, processing claims, and paying pharmacies through a separate pathway.
  • Reported medicines included in the demonstration are Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound and Foundayo, and beneficiaries must secure a prescription and prior authorization before coverage starts.
  • CMS has limited broad public outreach before launch and focused communications on providers and pharmacies to prepare workflows and prior-authorization processes that hospitals and health systems say remain complex.
  • The Bridge is temporary through December 2027, raising concerns about continuity of care, potential demand pressures, and how manufacturers, insurers, and policymakers will handle access and costs after the demonstration ends.