What the temporary program offers
The agency running this program is CMS, whose full name is Centers for Medicare & Medicaid Services.
GLP-1 is a natural body signal called a hormone; it affects blood sugar and hunger. Medicines that copy this signal are often called GLP-1 medicines. Depending on the medicine and its approved use, they can help with weight loss or type 2 diabetes.
As of September 2026, CMS’s temporary Medicare GLP-1 Bridge begins July 1, 2026 and lasts through December 31, 2027. People who qualify pay $50 for a monthly medicine supply; that payment is called a copay. CMS’s bridge program page
As of September 2026, the bridge pays separately from Part D, Medicare’s usual prescription-medicine coverage. Ordinary Part D still excludes medicines prescribed for weight loss or weight gain.
Ask the person writing your prescription to check these rules
As of September 2026, qualification for adults 18 or older depends on the following weight and health rules, assessed when treatment starts. BMI is a number based on height and weight; ask the doctor for yours. CMS’s eligibility and product rules
The weight rule alone
The bridge’s weight rule, as of September 2026, is met by a BMI of 35 or more without an added illness.
Weight and a health problem
As of September 2026, a BMI of 30 or more must go with at least one of these health problems:
- The heart-failure type called “heart failure with preserved ejection fraction”. Ask the doctor to check the full name of your diagnosis.
- Blood pressure remaining higher than 140 (top reading) or 90 (bottom reading) while taking two blood-pressure medicines.
- Stage 3a or more advanced kidney disease. Ask the doctor to check the stage, the medical rating of how severely the kidneys are affected.
Other qualifying health problems
As of September 2026, a BMI of 27 or more must go with pre-diabetes, a previous stroke or heart attack, or artery disease with symptoms in the arms or legs.
Plan and prescription checks
As of September 2026, a stand-alone Part D drug plan qualifies for the bridge’s plan rule. Some Medicare Advantage plans with drug coverage also qualify; ask the plan to confirm that yours is a “coordinated care” plan, one of the allowed types.
For the bridge to pay, a prescription and prior authorization—approval before payment—are required, as of September 2026. The medicine must be prescribed alongside an ongoing plan for nutrition and physical activity.
As of September 2026, type 2 diabetes or obstructive sleep apnea (blocked breathing during sleep) rated moderate to severe sends prescriptions to ordinary Part D, bypassing the bridge.
A particular liver disease also goes through Part D, as of September 2026. Ask the doctor to check for the full diagnosis “noncirrhotic MASH with moderate to advanced scarring” in the program’s rules. A fatty-liver diagnosis alone does not rule you out.
As of September 2026, prescriptions intended to reduce stroke or heart-attack risk also belong under Part D.
If Part D pays for any GLP-1 medicine in 2026, you cannot qualify for the bridge during 2026. As of September 2026, CMS had not decided which earlier medicine payments would affect qualification in 2027.
Ask and note
Does my care belong under Part D or under the bridge?
Check the bill and product separately
What the monthly payment does not cover
Part D has a yearly cap on your own spending for medicines it covers. Once you reach it, you stop paying for those covered medicines for the rest of that year. As of September 2026, bridge payments do not move you closer to that cap. You do not have to meet the Part D deductible—the amount normally paid before the plan starts paying—to use the bridge. CMS’s payment details
As of September 2026, people with low incomes receive no additional assistance toward the bridge payment. Coupons cannot lower it.
Ask separately what the first visit, lab work and later visits with the health professional would cost.
Confirm the product and form
As of September 2026, the bridge includes semaglutide (Wegovy) as shots or tablets, and orforglipron (Foundayo) as tablets. Tirzepatide (Zepbound) is included only in the KwikPen, an injection pen. CMS’s covered-product list
Zepbound’s single-dose pens and vials (small medicine bottles) are excluded from the bridge as of September 2026.
Ask and note
Is the exact product and form on my prescription included?