Medicare GLP-1 Bridge: $50/mo coverage explained.
Beginning July 1, 2026, eligible Medicare Part D beneficiaries can pay a flat $50/month copay for covered oral GLP-1 medications under the new CMS Bridge program. Here are the rules.
What's covered
- All Foundayo (orforglipron) formulations
- All Wegovy formulations (injection and the new 25 mg tablet)
- Zepbound — KwikPen formulation only (vials and standard pens excluded)
Rybelsus (oral semaglutide for T2D), Mounjaro (T2D tirzepatide), and Ozempic (T2D semaglutide) are NOT covered under the Bridge — Bridge eligibility requires an on-label chronic-weight-management indication.
Who's eligible
- Enrolled in Medicare Part D (PDP or MA-PD)
- BMI ≥ 27 with at least one qualifying comorbidity (cardiovascular disease, hypertension, prediabetes, CKD), OR BMI ≥ 35 alone
- Prior authorization processed via a CMS-managed central processor (not your individual Part D plan)
What it costs
A flat $50/month copay. The copay does NOT count toward your Part D deductible or the $2,100 annual out-of-pocket cap.
The Low-Income Subsidy (Extra Help) cannot be applied to Bridge drugs. If you qualify for Extra Help and your Part D plan covers a GLP-1 outside the Bridge, that may be a better path — talk to your plan.
How long it lasts
The Bridge program is currently authorized through December 31, 2027. CMS has signaled it transitions to the BALANCE Model in 2027.