What to know about the temporary Medicare GLP-1 Bridge program

Starting in July, some Medicare beneficiaries will be able to access GLP-1 medications by paying one flat fee per month. The temporary program is set to run for a year-and-a-half through the end of 2027.

But with less than two weeks before its launch, questions remain over how it will operate.  

The Medicare GLP-1 Bridge, described by the Centers for Medicare and Medicaid Services (CMS) as a “time-limited demonstration,” will officially run from July 1, 2026, to Dec. 31, 2027. 

Announced in December, the program will allow eligible Medicare Part D enrollees to access GLP-1 medications for a $50 monthly copay. Despite GLP-1s being indicated for diabetes, obesity and some heart conditions, the Bridge program will almost solely be available to beneficiaries seeking weight management solutions. 

The program is meant for Medicare beneficiaries who do not have a medically coverable indication for GLP-1s through Part D coverage. Federal law currently prohibits Medicare from covering weight loss medications. 

Organizations like the Obesity Care Advocacy Network (OCAN) have praised the program, with OCAN Coordinator Cristy Gallagher calling it a “historic milestone in the fight against the obesity epidemic.” 

There are some regulatory observers, however, who have concerns over how the program will be administered. And there are lingering questions over how much this will cost. Bob Herman of Stat News reported earlier this month that inquiries to CMS about the cost of the 18-month program have not been answered. 

The Hill also reached out to the Department of Health and Human Services for information on the program’s cost.

According to CMS, the program won’t require Medicare enrollees to fill out any additional paperwork or take any further steps past getting a prescription from their doctor. 

In order for a beneficiary to join the program, a medical provider must submit a prior authorization request and a prescription for one of the eligible GLP-1 medications. 

The medications that will be covered in the program include Wegovy, Zepbound and Foundayo. If a patient begins on one of these medications and switches to another in the middle of the Bridge program’s duration,........

© The Hill