The Centers for Medicare and Medicaid Services (CMS) announced that it will provide eligible Medicare beneficiaries access to certain GLP-1 medications for $50 per month beginning July 1, 2026, through Dec. 31, 2027 through the Medicare GLP-1 Bridge program.

Medicare GLP-1 Bridge Overview

Medicare GLP-1 Bridge is a short-term pilot program providing eligible Medicare Part D beneficiaries with access to certain GLP-1 medications at a cost of $50 per monthly supply.

Part D plan sponsors are not required to opt in and will not carry risk for GLP-1 drugs furnished under the program. CMS will manage prior authorization, claims adjudication, and pharmacy payments centrally through a single processor.

The program will be nationwide, available in all states and territories.

Eligibility & Participation

To qualify, Medicare beneficiaries must meet certain prior authorization criteria and be enrolled in a standalone prescription drug plan (PDP) or Medicare Advantage (MA) coordinated care plan that offers prescription drug coverage (MA-PD plans) in calendar year 2026.

Part D beneficiaries in special needs plans, employer/union group waiver plans, and the limited income newly eligible transition program are eligible to participate.

Beneficiaries enrolled in private fee-for-service plans, section 1876 cost contract plans, section 1833 health care prepayment plans, PACE organizations, fallback plans, and religious fraternal benefit plans are not eligible to participate, unless also enrolled in a standalone PDP, as applicable.

Additionally, dually eligible beneficiaries who are enrolled in eligible Part D plan types and meet the prior authorization criteria will have access to GLP-1 drugs via the Medicare GLP-1 Bridge.

Available GLP-1 Drugs

An eligible GLP-1 drug for the Medicare GLP-1 Bridge program is any of the following products when used to reduce excess body weight and maintain weight reduction:

  • Foundayo
  • Wegovy (injection and tablets)
  • Zepbound (KwikPen formulation only)

This list may be updated over the course of the program. See CMS’ Medicare GLP-1 Bridge webpage for the latest updates.

What Employers Should Know

Employers that sponsor prescription drug plans do not need to take any action to make the program available to eligible beneficiaries.

However, they should be prepared to direct Medicare-eligible employees to appropriate resources for guidance if they have questions.

This legal update is not intended to be exhaustive, nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.