What’s the Medicare GLP-1 Bridge program?
Starting July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) has a new program called the Medicare GLP-1 Bridge program.
If you qualify, you pay $50 a month for some weight-loss medications, like Foundayo™, Wegovy® (injection and tablet) and Zepbound® (KwikPen® only). The program ends on December 31, 2027. This is a CMS program that’s not part of an Aetna® Medicare plan. Watch this video to learn more.
Need help with weight loss? The Medicare GLP1 Bridge program may have a new option for you.
This program is separate from your regular Medicare drug plan. Your costs for the weight-loss drugs will not count toward your deductible or out-of pocket costs.
This is a limited-time program that may help eligible members pay less for some weight-loss medications. It is run by the Centers for Medicare and Medicaid Services, also known as CMS, not Aetna.
You may qualify if you are enrolled in a standalone Medicare Part D plan or a Medicare Advantage plan with drug coverage and you have a body mass index greater than or equal to 35 or a body mass index greater than or equal to 30 with a related health condition. This program is only for weight loss. If your doctor prescribes these medications for another condition and they are already covered by your Medicare plan, you will not be eligible for the bridge program.
Talk to your doctor to see if this program is right for you.
If you qualify, you will pay $50 for a one-month supply. The price is the same for all eligible members, even if you have low-income subsidy help.
Only certain GLP-1s are eligible for this program, such as Foundayo®, Wegovy@, and Zepbound.
Getting started is simple. First, talk to your medical provider. They'll review your health needs and decide if this treatment may be right for you. If so, they'll submit a request to the Medicare GLP-1 Bridge program.
Your request will be reviewed by Medicare. If approved, you can fill your prescription at a participating pharmacy.
Talk to your doctor today to see if this program could help you.
For more information, visit bit.ly/gp1bridge or call Medicare at 1-800-MEDICARE.
This program is run by the Centers for Medicare and Medicaid Services and is not part of your Aetna benefits.
Who qualifies for the Medicare GLP-1 Bridge program?
You may qualify if:
- You have a Medicare Part D plan such as a:
- Medicare Advantage prescription drug (MAPD) plan: This is a Medicare Advantage plan that includes prescription drug coverage.
- Special Needs Plan (SNP): Some Special Needs Plans, like D-SNPs, C-SNPs and I-SNPs, may also include prescription drug coverage.
- Prescription drug plan (PDP): This is a stand-alone Medicare drug plan.
- You want a GLP-1 drug for weight loss only, not for Type 2 diabetes or another condition.
- You meet the CMS health requirements, such as being diagnosed with obesity.
- Your plan doesn’t cover the drug.
- Your doctor says you need a GLP-1 for weight loss only.
You won't qualify if:
Your GLP-1 medication is covered through Medicare Part D (MAPD, SNPs and PDP) and is used to treat:
- Type 2 diabetes: A health condition where your blood sugar is too high.
- Sleep apnea: A sleep problem where your breathing stops and starts while you sleep.
- MASH: A liver disease where fat builds up in the liver and causes swelling or damage.
If you have one of these conditions, talk to your doctor. Your Part D plan may cover your GLP-1 drug.
How do I get approved for the Medicare GLP-1 Bridge program?
To get approved, your doctor needs to send a request to CMS. This is called prior authorization. It means your doctor must ask for approval before you can get the medication. Aetna Medicare does not approve requests for the Medicare GLP-1 Bridge program.
What’s the difference between the Medicare GLP-1 Bridge program and my Part D coverage?
This chart explains the differences:
| Question | Medicare GLP-1 Bridge program | Medicare Part D |
|---|---|---|
| Who runs it? | CMS (the government program) | Your plan (from insurance companies like Aetna Medicare.) |
| What does it cover? | Weight-loss medications only | Medications may be covered by Medicare Part D for certain health conditions like Type 2 diabetes, sleep apnea and MASH. |
| What's the cost? | $50 per month | It depends on your plan and the drug list. |
| Does this replace my Part D coverage? | No. This program doesn’t replace your Part D coverage. | No. Your Part D plan may still help pay for drugs it covers. |
| Does this count toward my deductible or yearly out-of-pocket maximum? | No. What you pay for this program doesn’t count toward your Part D deductible or out-of-pocket maximum. | It may. Costs for Part D drugs might count toward your deductible and out-of-pocket drug costs. It depends on your plan. |
How can I get started?
To get started, talk to your doctor. Ask if a GLP-1 weight-loss medication is right for you and whether you meet the program rules:
- Step 1: Talk to your doctor. Your doctor checks your health history and whether the medication is for weight loss only.
- Step 2: Check your drug coverage. You must have Medicare Part D drug coverage.
- Step 3: Make sure the drug is covered. The Bridge program only covers certain GLP-1 medications for weight loss like Foundayo™, Wegovy® (injection and tablet) and Zepbound® (KwikPen® only).
- Step 4: Your doctor asks CMS for approval by submitting a prior authorization. CMS reviews the request and checks if you qualify.
- Step 5: If you’re approved, you pay $50 for a 30-day supply at a participating pharmacy.
Where can I learn more about the Medicare GLP-1 Bridge program?
Call 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048) or visit CMS.gov for the latest information.
Common questions about the Medicare GLP-1 Bridge program
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The Medicare GLP-1 Bridge program covers three medications approved for weight-loss:
- Foundayo™
- Wegovy® (injection and tablet)
- Zepbound® (KwikPen® only)
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No. Ozempic isn't part of the Medicare GLP-1 Bridge program. It may still be covered under your Part D plan if prescribed for Type 2 diabetes. This depends on your plan's drug list. Visit the Does Medicare Part D cover GLP-1 drugs like Ozempic? page for more details.
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Yes, you may be able to use it if your Medicare Advantage plan includes Part D drug coverage, and you meet the rules of the program. This could be an MAPD plan or a SNP (I-SNP, D-SNP or C-SNP).
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How much you pay for a GLP-1 medication depends on how you get it. If you use the Medicare GLP-1 Bridge program, you pay $50 for a 30-day supply. This $50 does not count toward your yearly Out-of-Pocket Maximum (OOP).
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Yes. Your doctor sends a request to CMS. CMS checks the request to see if you qualify. This is called prior authorization. This means your doctor must ask for approval before you can get the medication through the program.
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The Medicare GLP-1 Bridge program starts on July 1, 2026, and ends on December 31, 2027.
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