Let's set the stage. By law, Medicare drug plans have long been allowed to exclude drugs used for weight loss, and Part D has excluded them. In 2026 CMS opened a short term program, the Medicare GLP-1 Bridge, that runs outside the normal Part D benefit. It started July 1, 2026, and prior authorizations are valid through December 31, 2027, per Medicare.gov.
Medicare GLP-1 Bridge at a glance
| Item | Details |
|---|---|
| Dates | July 1, 2026 through December 31, 2027 |
| Your cost | $50 copay for a one month supply |
| Drugs | Wegovy (injection or tablet), Zepbound (KwikPen only), Foundayo (tablet) |
| Who can use it | People with Medicare drug coverage: stand-alone Part D, Medicare Advantage coordinated care plans with drug coverage, special needs plans, employer or union plans, and LI NET |
| Prior authorization | Required, submitted by your prescriber |
| Counts toward the Part D cap? | No. It does not count toward your deductible or the $2,400 out-of-pocket limit |
Who qualifies
You must be 18 or older and meet one of these, per Medicare.gov and CMS prescriber guidance:
- BMI of 35 or higher, or
- BMI of 30 or higher with heart failure with preserved ejection fraction, uncontrolled high blood pressure, or stage 3a or higher chronic kidney disease, or
- BMI of 27 or higher with prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease.
The criteria are judged at the time you started GLP-1 therapy. People with type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease (MASH) are not eligible for the Bridge, because their regular Part D plan might cover a GLP-1 for those conditions.
What about Wegovy for heart disease?
Wegovy is also approved to reduce heart risk in people with cardiovascular disease and obesity or overweight, and CMS lists that among its commonly treated conditions in the 2027 negotiation fact sheet. Coverage for that use goes through your regular drug plan's formulary and prior authorization rules, not the Bridge.
Wegovy's 2027 negotiated price
Wegovy was negotiated together with Ozempic and Rybelsus. Starting January 1, 2027, the Medicare negotiated price for four 2.4 mg/0.75 mL Wegovy pens is $385.63, per CMS. That price matters when Wegovy is covered under the regular Part D benefit. In the Bridge, your cost is the flat $50 copay.
How to use the Bridge, step by step
- Talk with your doctor about whether you meet the BMI and condition criteria.
- Your doctor submits the Medicare GLP-1 Bridge prior authorization.
- Once approved, fill at a pharmacy and pay the $50 copay.
- Remember the payments do not show on your Part D Explanation of Benefits and do not count toward your drug cap.
- Plan ahead for 2028. The Bridge ends December 31, 2027, and what replaces it has not been announced.
Here's the thing. Because the Bridge sits outside Part D, your 2027 plan choice still matters for everything else you take. Price your other drugs as usual.
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Frequently asked questions
Does Medicare Part D cover Wegovy for weight loss in 2027?
Regular Part D does not cover weight loss drugs. Eligible people can get Wegovy for a $50 monthly copay through the Medicare GLP-1 Bridge, which runs through December 31, 2027.
Can Medicare Advantage members use the GLP-1 Bridge?
Yes, if they are in a Medicare Advantage coordinated care plan with drug coverage. Medicare.gov also lists stand-alone Part D plans, special needs plans, employer or union plans and LI NET.
Does the $50 GLP-1 Bridge copay count toward the Part D out-of-pocket cap?
No. Medicare.gov says it does not count toward your Part D deductible or yearly out-of-pocket limit, and it does not appear on your Explanation of Benefits.
What BMI do I need for Medicare to cover Wegovy?
A BMI of 35 or higher, or 30 or higher with certain conditions such as uncontrolled high blood pressure, or 27 or higher with conditions such as prediabetes or a previous heart attack. Your prescriber submits a prior authorization.
Sources
- Medicare.gov: Weight loss drugs and the Medicare GLP-1 Bridge
- Medicare.gov fact sheet: Medicare GLP-1 Bridge, GLP-1 drugs for $50 a month
- CMS: Medicare GLP-1 Bridge, information for providers
- CMS fact sheet: Negotiated prices for initial price applicability year 2027
- Social Security Act section 1927(d)(2), drugs plans may exclude, including agents for weight loss
Updated October 13, 2026 by the Everything Senior Insurance Data Desk.