The Centers for Medicare & Medicaid Services, led by Dr. Mehmet Oz, launched the Medicare GLP-1 Bridge pilot program on July 1, 2026. The 18-month initiative allows eligible Medicare beneficiaries to access popular weight-loss drugs like Wegovy and Zepbound for a flat $50 monthly copay. While the program dramatically lowers financial barriers for millions of older Americans, its scheduled expiration at the end of 2027 has sparked significant concern among healthcare providers regarding long-term treatment continuity and potential weight regain.
Medicare Bridge pilot program
- ▪The Centers for Medicare & Medicaid Services launched an 18-month pilot program called Medicare GLP-1 Bridge on July 1, 2026
- ▪The Medicare GLP-1 Bridge program is funded by taxpayer dollars and beneficiary copays rather than private Part D insurers
- ▪The Medicare GLP-1 Bridge program covers Eli Lilly's Zepbound and Foundayo, and Novo Nordisk's Wegovy
GLP-1 eligibility criteria
- ▪To qualify for the Bridge program, Medicare beneficiaries must have a body mass index of 35 or higher, or a BMI of 27 or higher with a related health condition
- ▪Medicare beneficiaries with Type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease are excluded from the Bridge program
Patient copay structure
- ▪Eligible participants in the Medicare GLP-1 Bridge program pay a flat copay of $50 per month for the covered medications
- ▪The $50 monthly copay for the Bridge program does not count toward a patient's Part D deductible or the $2,100 annual out-of-pocket cap
Prior authorization process
- ▪The Centers for Medicare & Medicaid Services expects prior authorization requests for the Bridge program to be processed within 72 hours of receipt
- ▪Healthcare providers must submit prior authorization requests to Humana, which was contracted by CMS to process approvals for the Bridge program
Program expiration uncertainty
- ▪The Medicare GLP-1 Bridge program is scheduled to expire on December 31, 2027
- ▪A 2022 study indicates that patients who stop taking Wegovy regain approximately two-thirds of their lost weight within one year
Pharmaceutical company competition
- ▪Eli Lilly held 60.1% of the U.S. obesity and diabetes drug market in the first quarter of 2026, while Novo Nordisk held 39.4%.
- ▪Leerink Partners analyst David Risinger projects the Bridge program could generate over $1 billion in annual revenue for both Eli Lilly and Novo Nordisk
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