Medicare to Test Coverage of Certain Weight-Loss Drugs

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Beginning July 1, 2026, Medicare will launch a temporary GLP-1 Bridge Program that gives some beneficiaries access to certain weight-loss medications, including Wegovy, Zepbound, and Foundayo. The program will run through December 31, 2027.

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To qualify, beneficiaries must be age 18 or older, have Medicare prescription drug coverage through a Part D or Medicare Advantage drug plan, obtain prior authorization, and meet specific weight and health criteria. Eligibility generally requires a BMI of 35 or higher, or a lower BMI combined with certain health conditions or risk factors.

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Participants will pay a fixed $50 monthly copayment. Because the Bridge Program operates separately from Medicare Part D, the copay will not count toward Part D deductibles or out-of-pocket limits, and Extra Help cannot be used to reduce the cost.

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The program was created because Medicare generally cannot cover medications prescribed solely for weight loss under current federal law. SHIBA counselors can help explain eligibility requirements and how the program works.

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Questions about Medicare coverage? SHIBA counselors provide free, unbiased Medicare counseling. Call SHIBA at 360-586-6181 ext. 134 or 1-800-562-6900 for assistance.  

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