Millions of Medicare patients will be eligible for GLP-1 weight-loss drugs like Ozempic and Wegovy at a cut-rate $50 per month under an upcoming government program.
Up to 14 million Medicare recipients are overweight and could qualify for the discounted drug program — known as the Medicare GLP-1 Bridge — which rolls out July 1 and continues through 2027.
It’s part of a program President Trump announced in November to drastically lower drug costs for Americans, with the president striking a deal with some of the leading GLP-1 makers to provide the drugs at a low “most favored nation” rate.
Ozempic retails for more than $1,000 a month, and the weight-loss variant of the drug, Wegovy, is listed for $1,350. There are some work-arounds to save money, but no cheap generic versions because they are still new medications under patent.
That makes the GLP-1 Bridge program a rare opportunity for people to get their hands on the weight-loss drugs at a small fraction of the usual price.
Here is everything you need to know about the new program.
What is the Medicare GLP-1 Bridge?
GLP-1 prescriptions were previously available for Medicare patients dealing with conditions like diabetes, sleep apnea, and cardiovascular disease — but were not available for weight loss, the treatment that’s made headlines as patients shed dozens of pounds on the drug.
The Medicare Bridge widens which Medicare users qualify for GLP-1 prescriptions — making prescriptions available for patients who want to take it for weight loss.
This program is a short-term pilot to gauge the feasibility of a larger program — accounting for the “Bridge” part of the title.
A permanent plan for GLP-1s could begin rolling out in 2028.
How long will the program run, and what happens after?
The Bridge program runs from July 1, 2026, to Dec. 31, 2027.
It remains unclear if it will continue after 2027, as the Bridge program’s purpose is to see how much demand there will be for GLP-1s so insurance companies can gauge whether they will participate.
Insurer participation is vital to make a long-term GLP-1 weight-loss Medicare program feasible, as the government would depend on them to subsidize the costs of the huge of the GLP-1s discounts.
The government would be on the hook for billions of dollars if insurers don’t sign up, with the Congressional Budget Office estimating the program would cost taxpayers about $35 billion from just 2026 to 2034, according to the New York Times.
Such a cost could prevent a long-term program from being affordable — especially as the federal government looks to tamp down on entitlement spending.
Who qualifies for the program?
Most Medicare patients 65 years and older who are overweight qualify for the program.
That means you must have a body mass index (BMI) of 35 to automatically qualify, or a BMI of 27 and an obesity-associated condition like pre-diabetes and heart disease, according to NPR.
You must also been enrolled in a Medicare Part D plan, which covers prescription medications.
If you are already taking a GLP-1 through Medicare for another condition, you may not qualify for the $50 copay.
What GLP-1 drugs are covered by the Bridge program?
Three GLP-1s will be available under the program — Zepbound, Foundayo and Wegovy.
Foundayo and Wegovy are available as pill, rather than injectables.
Ozempic, which is primary used to treat diabetes and not for weight loss, is not part of the program.
The drugs are typically very expensive, but will be available under the Bridge program for a fraction of their usual cost.
Zepbound typically costs $699 per month — if patients pay cash.
Wegovy, a pill, costs between $199 and $399 per month.
And the Foundayo pill can cost up to $349 per month.
The drugs are from the makers Eli Lilly and Novo Nordisk, which were central to President Trump’s “most favored nation” deal.
How do you participate in the program?
Patients will not go through their usual Medicare Part D program to obtain GLP-1 prescriptions through the Bridge program.
Instead, they must obtain a prior-authorization from a doctor who will submit that paperwork through the platform Humana.
Any doctor can provide the prior-authorization — they do not need to be Medicare providers.
Patients will then be able to fill their prescriptions at a pharmacy, where they will only have to pay the program’s $50 co-pay.
What are some program downsides?
The Bridge program provides deals only on the weight-loss drugs — none of the counseling that typically accompanies somebody trying to shed serious pounds to improve their health, Axios reported.
With the Bridge program providing weight-loss drugs for people older 65, that could become problematic for patients who lose too much weight but don’t have accompanying treatment and counseling.
Making a meaningful difference in health also requires more than just a drug — nutrition, diet and exercise are required to keep pounds off and stay healthy, doctors say.
Most GLP-1 users also typically gain weight back when they stop taking the drug unless they’ve made significant changes to their lifestyle in tandem — so if the Bridge program does not continue after it ends in 2027, that could have health consequences for patients.
