Major change Jul 1, 2026
Insurance coverage for 2026 GLP-1s.
Three coverage paths — Medicare GLP-1 Bridge, commercial insurance, and direct-from-manufacturer cash. Here's how to find your cheapest route.
Cheapest if eligible
Medicare Bridge
$50/mo
Flat copay for Foundayo, all Wegovy formulations, and Zepbound KwikPen. Eligible Part D beneficiaries with BMI ≥ 27 + comorbidity (or ≥ 35 alone).
Bridge eligibility guide → Most common
Commercial insurance
$25–$60/mo
Through your plan's formulary, with prior auth. Pair with manufacturer savings card (Foundayo $25/mo) for the lowest copay.
Most plans require: BMI ≥ 30 (or ≥ 27 + comorbidity), prior auth, sometimes step therapy through metformin.
Backup
Cash pay
$149+/mo
Direct from manufacturer (LillyDirect, NovoCare) or through a telehealth partner (Ro, Hims). No prior auth, no insurance required.
Compare providers →Find your coverage path
Estimated monthly out-of-pocket by medication, based on your coverage situation.
| Medication | Route | Est. monthly | Notes |
|---|
No medications match your filters. Try widening the route preference.
Frequently asked questions
Does Medicare cover oral GLP-1s in 2026?
Yes — under the new Medicare GLP-1 Bridge program, eligible Part D beneficiaries pay a flat $50/month copay for covered medications starting July 1, 2026. Read the full guide.
What's the difference between commercial insurance and Medicare for GLP-1s?
Commercial plans generally require prior authorization and may impose step therapy. Medicare Part D under the Bridge program uses a CMS-managed central processor (not your individual plan) for prior auth and a flat $50 copay.
Can I use a manufacturer savings card with Medicare?
No. Manufacturer savings cards (e.g., the Foundayo $25/mo card) are restricted to commercial insurance only — federal benefits including Medicare, Medicaid, and TRICARE are excluded by federal anti-kickback rules.
What if my insurance doesn't cover GLP-1s?
Direct-from-manufacturer cash-pay programs are the next best option. Foundayo starts at $149/mo via LillyDirect; Wegovy Tablets at $149/mo via NovoCare. Zepbound vials start at $299/mo.
How do I find out if my insurance covers a specific GLP-1?
Use the Coverage Finder above to see estimated monthly cost for every 2026 GLP-1 by coverage situation (Medicare Bridge, commercial, cash, Medicaid). For a definitive answer on your specific plan, check your plan's formulary or ask your pharmacist to run a test claim.