Medicare GLP-1 Bridge explained: $50 Wegovy and Zepbound

What is the Medicare GLP-1 Bridge?

By law, Medicare drug plans (Part D) can't cover drugs used only for weight loss. The Medicare GLP-1 Bridge is a temporary program from CMS, the agency that runs Medicare, that works around this. It covers certain GLP-1 drugs for weight loss for people who already have Part D.

It began July 1, 2026. It was first set to end December 31, 2026, but CMS extended it, and it now runs through December 31, 2027 (CMS). It works in every state and U.S. territory (Medicare.gov).

How much does it cost?

You pay $50 for a one-month supply at the pharmacy. That's it. The Bridge runs outside your Part D plan, so the $50 stays the same all year.

Part D normally has phases: a deductible (you pay full price up to a set amount), then initial coverage (you pay a copay), then a cap on your yearly out-of-pocket costs ($2,100 in 2026, $2,400 in 2027). Under the Bridge, the copay is $50 no matter which phase you're in (KFF).

A few things follow from that (Medicare.gov):

• The $50 doesn't count toward your Part D deductible or yearly out-of-pocket cap.
• Extra Help (Medicare's low-income subsidy) can't lower it.
• The Medicare Prescription Payment Plan can't spread it across months.
• Each fill is one month (28 or 30 days). There are no 60- or 90-day fills (CMS).

Which drugs does the Bridge cover?

Source: CMS information for providers. Pen needles for the Zepbound KwikPen aren't covered by the Bridge, so you'll need to get those separately.

Who is eligible?

You need all of these (Medicare.gov):

• Medicare drug coverage. That includes a standalone Part D plan, a Medicare Advantage plan with drug coverage, a Special Needs Plan, an employer or union Medicare plan, or LI NET.
• Age 18 or older.
• A prescription for weight loss, and a doctor who certifies you're using it along with a diet and exercise program.
• Prior authorization, meaning your doctor sends paperwork showing you meet the rules below before coverage starts.

You also need to meet one of these BMI rules when you start the drug:

Source: CMS information for providers.

You are not eligible for the Bridge if:

• You have type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease (MASH). Your Part D plan may cover a GLP-1 for these instead.
• Your Part D plan already covers a GLP-1 for you. CMS says anyone who filled a GLP-1 through Part D in 2026 can't use the Bridge in 2026, and it hasn't yet said how it will check this in 2027 (CMS).
• The drug is prescribed to lower your heart attack and stroke risk. That goes through your Part D plan.
• You're only in a plan type CMS excludes, such as private fee-for-service, a cost plan or PACE, without a standalone Part D plan.

How do I start?

1. Talk to your doctor or other prescriber about whether a covered GLP-1 is right for you.
2. Your doctor sends the prescription to your pharmacy.
3. Your doctor completes the prior authorization when the pharmacy asks for it. Decisions usually come within 72 hours.
4. Your pharmacy may ask for your Medicare Number or the last 4 digits of your Social Security Number.
5. You get a letter in the mail confirming your coverage.

Once approved, your prior authorization lasts through December 31, 2027, including refills and dose changes, unless you switch to a different GLP-1 (Medicare.gov). There's no formal appeal if you're denied, but your doctor can send a corrected request (CMS).

Can I use a coupon or savings card with the Bridge?

No. CMS says coupons and discount programs can't be applied to Bridge claims, no matter who pays for them. The $50 is yours to pay (CMS). The makers' savings cards also exclude people with Medicare.

What should I check during Open Enrollment?

Medicare Open Enrollment runs October 15 to December 7. Changes take effect January 1 (Medicare.gov). Because the Bridge sits outside Part D, the $50 price doesn't depend on which plan you pick. But your plan still matters:

• No Part D yet? You need it to use the Bridge. Open Enrollment is usually when you can add it.
• Is the plan type eligible? Standalone Part D and most Medicare Advantage plans with drug coverage are.
• Does the plan cover a GLP-1 for you some other way? If you have diabetes, heart disease or sleep apnea, check the plan's formulary (its list of covered drugs) for your GLP-1 and its copay.
• Are your other medicines covered, and at what cost? Pick a plan for everything you take, not just the GLP-1.

What happens after 2027?

Nobody knows yet. CMS extended the Bridge to collect data "ahead of potential implementation" of a longer-term program called BALANCE in Part D (CMS). KFF notes that if neither happens, people could lose this coverage in 2028 (KFF). Watch for news before Open Enrollment in fall 2027.

What happened to the BALANCE model in Medicare?

The BALANCE model was meant to let Part D plans cover GLP-1s for weight loss starting in January 2027. On April 21, 2026, CMS said it would not launch BALANCE in Medicare in 2027, because not enough Part D plans signed up, and extended the Bridge instead. It hasn't set a new start date (KFF). The Medicaid part of BALANCE is going ahead, state by state (CMS).

Why isn't Ozempic covered by the Bridge?

The Bridge covers only GLP-1s approved for weight loss (KFF). Ozempic is approved for type 2 diabetes, not weight loss (Ozempic.com), and Mounjaro isn't on the list either. If you have type 2 diabetes, your regular Part D plan can cover these drugs, with its own rules and copays. Wegovy has the same active ingredient as Ozempic and is on the Bridge list.

For every other way to pay, see our guide: How to pay for Ozempic, Wegovy and Zepbound in 2026.