Can Medicare Pay for Wegovy or Zepbound? The GLP-1 Bridge
Since July 1, 2026, Medicare GLP-1 Bridge lets eligible people with Part D get Wegovy, Zepbound KwikPen or Foundayo for weight management for a $50 monthly copay. Here is who qualifies and how to start.
Key takeaways
- Medicare GLP-1 Bridge is a temporary CMS program that runs from July 1, 2026 to December 31, 2027, outside the normal Part D benefit.
- It covers Foundayo (tablet), Wegovy (injection or tablet) and Zepbound KwikPen only, for a $50 copay for a one-month supply.
- You need Medicare drug coverage, must be 18 or older, and must meet BMI rules. People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease are not eligible, because their own plan may cover a GLP-1.
- The $50 does not count toward your Part D deductible or yearly out-of-pocket limit, and Extra Help does not lower it.
- Your doctor starts it: a prescription, then a prior authorization. Medicare sends you a letter when the drug is approved.
Yes, some people with Medicare can now get a GLP-1 weight management drug for $50 a month. Medicare GLP-1 Bridge started July 1, 2026. It covers Wegovy, the Zepbound KwikPen and Foundayo for people with Part D drug coverage who meet set health criteria, and it runs through December 31, 2027.
Until now, Part D could not pay for drugs used only for weight loss. That is why so many people in Brighton and across Colorado have asked Lisa Asmussen why Medicare covers Ozempic for a neighbor with diabetes but not for them. The Bridge is a separate, temporary program that fills part of that gap.
It has firm rules, and a few of them surprise people, such as the $50 not counting toward the drug cap. Here is what CMS and Medicare.gov say, in plain English, and how to tell whether it fits you.
What is the Medicare GLP-1 Bridge?
Medicare GLP-1 Bridge is a short-term CMS program that lets eligible people with Medicare drug coverage get certain GLP-1 drugs for weight management at a set $50 copay. CMS describes it as operating outside the Medicare Part D benefit's coverage and payment flow. A single central processor handles prior authorization, claims and payment to pharmacies.
- program start
- Jul 1, 2026
- program end
- Dec 31, 2027
- your copay for a one-month supply
- $50
- drugs covered: Foundayo, Wegovy, Zepbound KwikPen
- 3
Your Part D plan does not have to opt in. If you qualify, you can use the Bridge whichever Medicare drug plan you have, including a stand-alone Part D plan or a Medicare Advantage plan with drug coverage.
Which drugs does it cover, and what will I pay?
Three drugs, at $50 for a one-month supply (28 or 30 days, depending on the drug). The price is the same whatever your income.
| Drug | Form covered | Not covered |
|---|---|---|
| Foundayo | Tablet | |
| Wegovy | Injection or tablet | |
| Zepbound | KwikPen only | Single-dose Zepbound vials or pens |
Am I eligible for the GLP-1 Bridge?
You are eligible if you have Medicare drug coverage, are at least 18, do not already get a GLP-1 through your plan, do not have one of three excluded conditions, and meet one of the BMI rules when you start the drug.
- You have Medicare drug coverage. A stand-alone Part D plan, a Medicare Advantage plan with drugs (HMO, HMO-POS, local or regional PPO), a Special Needs Plan, an employer group Medicare plan or LI NET.
- Your plan does not already cover a GLP-1 for you. If your plan pays for a GLP-1 today, for any reason, you keep getting it through your plan.
- You do not have type 2 diabetes, moderate to severe sleep apnea or fatty liver disease. With those conditions, your own drug plan may cover a GLP-1, so call your plan.
- You are 18 or older and meet one BMI rule (below).
| Body mass index (BMI) | Plus at least one of these |
|---|---|
| 35 or higher | Nothing else needed |
| 30 or higher | Diastolic heart failure, uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher |
| 27 or higher | Prediabetes, a previous heart attack or stroke, or peripheral artery disease with symptoms |
If you do not know your BMI, your doctor can calculate it from your height and weight at your next visit.
How do I get a GLP-1 through the Bridge?
Your doctor and pharmacy do most of the work. The process starts with a normal prescription and ends with a letter from Medicare.
- Confirm you have Medicare drug coverage. Your plan card will show it.
- Talk to your doctor about whether one of the three drugs is right for you, and ask them to send a prescription to your pharmacy.
- Complete the prior authorization when asked. Your provider must certify that you are using the drug as part of a diet and exercise lifestyle program.
- Give the pharmacy your Medicare Number if they ask. They can also use the last four digits of your Social Security Number.
- Watch your mail for a Medicare letter saying the drug is covered under the Bridge, then pick it up and pay $50.
How does this fit with Ozempic coverage in Colorado?
Ozempic is a different situation. It is approved for type 2 diabetes, and Part D plans cover it for that use, so it is not part of the Bridge. It is widely used here: CMS data show 19,699 Colorado Part D members filled Ozempic in 2024, at an average gross cost of $889.59 per 30-day fill before rebates.
Prices are also changing. CMS set a Medicare negotiated price of $274 for a 30-day supply of semaglutide (Ozempic, Rybelsus and Wegovy), effective January 1, 2027, against a $959 list price. Your own copay still depends on your plan, its tiers and its deductible, and the 2027 Part D out-of-pocket cap is $2,400.
Through your Part D plan
- GLP-1s for type 2 diabetes and other covered uses
- Copay set by your plan's tier and deductible
- Counts toward the yearly Part D cap
- Extra Help can lower the cost
Through Medicare GLP-1 Bridge
- Foundayo, Wegovy, Zepbound KwikPen for weight management
- $50 for a one-month supply
- Does not count toward the Part D cap
- No Extra Help reduction
What should I do during open enrollment?
Keep a Part D plan that covers your other medicines well, because the Bridge only works if you have Medicare drug coverage. If you are thinking of changing plans during open enrollment, October 15 to December 7, 2026, and you use the Bridge, call 1-800-MEDICARE first to ask how the change affects your approval.
If you have diabetes and take a GLP-1 through your plan, check how your 2027 plan lists it: the tier, any prior authorization, and the deductible. Our post on Part D planning for 2027 shows how Colorado drug plan premiums and deductibles changed.
The bottom line
Medicare GLP-1 Bridge gives eligible people with Medicare drug coverage Wegovy, the Zepbound KwikPen or Foundayo for $50 a month through December 31, 2027. It has firm BMI and health rules, it sits outside your Part D totals, and your doctor has to start the prior authorization. Keep a drug plan that covers everything else you take, and ask before you assume you do or do not qualify.
Frequently asked questions
Does Medicare cover Wegovy for weight loss?
Through Medicare GLP-1 Bridge, yes, from July 1, 2026 to December 31, 2027, for eligible people with Medicare drug coverage. The copay is $50 for a one-month supply.
Does the GLP-1 Bridge $50 count toward my Part D out-of-pocket limit?
No. The $50 copay does not count toward your Part D deductible or yearly out-of-pocket limit, and it does not appear on your Part D Explanation of Benefits.
Can I use the GLP-1 Bridge if I have type 2 diabetes?
No. People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease are not eligible for the Bridge, because their Medicare drug plan may already cover a GLP-1 for them. Check with your plan.
Is the Zepbound vial covered by the GLP-1 Bridge?
No. Only the Zepbound KwikPen is covered. Single-dose Zepbound vials or pens are not.
Sources
- CMS: Medicare GLP-1 Bridge Centers for Medicare & Medicaid Services
- Medicare.gov: Medicare GLP-1 Bridge Centers for Medicare & Medicaid Services
- CMS Medicare Part D Prescribers by Geography and Drug, 2024 Centers for Medicare & Medicaid Services
- CMS fact sheet: negotiated prices for initial price applicability year 2027 Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Currently we represent 10 organizations which offer 106 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Headwaters Health and Wealth is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information. This article is general information, not medical, tax or legal advice.
