Medicare GLP-1 Bridge: $50 a Month for Wegovy, Zepbound & Foundayo Through 2027

Last updated September 22, 2026

If you’re on Medicare and you’ve been told weight-loss GLP-1s “aren’t covered,” that’s no longer the whole story. Since July 1, 2026, a federal program called the Medicare GLP-1 Bridge has let eligible Part D enrollees get Wegovy, Zepbound or Foundayo for a flat $50 a month. And it now runs through December 31, 2027 — a full year longer than first planned.

Here’s exactly who qualifies, what’s covered, and how to actually get it filled.

The short version

• What it costs you: $50 per monthly supply.
• Which drugs: Foundayo (all strengths), Wegovy (injection and tablets), and Zepbound KwikPen.
• Who: Adults 18+ enrolled in Medicare Part D who meet specific BMI and health criteria (below).
• How long: July 1, 2026 through December 31, 2027.
• How: Your prescriber submits a prior authorization to a central Medicare processor — not your Part D plan.

Why it was extended to 2027

The Bridge was designed as a stopgap until a larger program — the BALANCE Model — took over GLP-1 coverage inside Part D plans in 2027. On April 21, 2026, CMS delayed the Part D portion of BALANCE “pending further evaluation and data collection” and extended the Bridge through December 31, 2027 so Part D enrollees keep access in the meantime (AHA News). The Medicaid side of BALANCE is still moving forward state by state.

If you read earlier coverage saying the Bridge ends December 31, 2026, that information is out of date.

Who qualifies

You must be 18 or older, enrolled in Medicare Part D, and meet one of these (CMS):

• BMI of 35 or higher, or
• BMI of 30 or higher plus heart failure, uncontrolled high blood pressure, or chronic kidney disease stage 3a or worse, or
• BMI of 27 or higher plus prediabetes, a prior heart attack, a prior stroke, or peripheral artery disease.

Not sure where you land? Our BMI calculator takes 10 seconds.

Who the Bridge is not for

People with type 2 diabetes, obstructive sleep apnea, or MASH (fatty liver disease with inflammation) are excluded from the Bridge — because regular Part D already covers GLP-1s for those conditions. If that’s you, your coverage runs through your own Part D plan at your plan’s normal cost-sharing, which may be more or less than $50.

What’s covered — and the one formulation catch

That Zepbound detail matters: if your prescription is written for vials, ask your prescriber to switch it to the KwikPen before the prior authorization goes in. Weighing a pill against an injection? See our Wegovy pill vs. injection breakdown and tirzepatide vs. semaglutide.

How to get it, step by step

1. Book a visit with your prescriber. They confirm you meet the criteria and document your BMI and qualifying conditions.
2. Your prescriber submits the prior authorization to Medicare’s central Bridge processor. This does not go through your Part D plan.
3. The prescription goes to a participating pharmacy, which bills the Bridge system.
4. You pay $50 per monthly supply at pickup.

Approvals can take up to 72 hours, so don’t wait until your last dose to start (Medicare Rights Center). Our free GLP-1 Supply Tracker tells you when to reorder so you don’t run short.

Fine print worth knowing

• The $50 copay does not count toward your Part D deductible or annual out-of-pocket cap.
• Extra Help (Low-Income Subsidy) does not apply to Bridge prescriptions — the $50 is the price.
• Part D plans don’t have to opt in. The Bridge runs alongside your plan, so you only need to stay enrolled in Part D.

What to do during open enrollment (Oct 15 – Dec 7)

Medicare open enrollment is when you can change Part D plans for 2027. For Bridge purposes, the key is simple: keep Part D coverage — dropping it ends your eligibility. If you also take other prescriptions, compare 2027 plans on those drugs; the Bridge handles the GLP-1 separately.

Before your appointment

Prior authorizations get approved faster when the chart already shows your BMI, your qualifying conditions, and what you’ve tried before. Our Doctor Visit Prep Kit walks you through exactly what to bring and ask. For every other way to lower the cost, see Cost & Access.

Sources

• CMS — Medicare GLP-1 Bridge: Information for Part D Plans
• CMS — CMS to Provide $50 Monthly Access to GLP-1 Medications (May 6, 2026)
• AHA News — CMS delays Part D portion of BALANCE Model (April 22, 2026)
• Medicare Rights Center — GLP-1 Weight-Loss Drug Demonstration Begins July 2026

This article is for informational purposes only and is not medical or insurance advice. Program rules can change — confirm eligibility with your prescriber and Medicare (1-800-MEDICARE) before making decisions.