Wegovy Medicare GLP-1 Bridge Program

Eligibility

Beginning July 1, 2026, eligible Medicare beneficiaries may be able to access Wegovy® for covered FDA-approved indications for no more than $50 per month through the Medicare GLP-1 Bridge Program.

Medicare GLP-1 Bridge Eligibility

  • Be enrolled in Medicare Part D.
  • Be enrolled in an eligible Medicare prescription drug plan.
  • Use a GLP-1 medication to reduce excess body weight and maintain weight reduction.
  • Meet Medicare GLP-1 Bridge clinical criteria and prior authorization requirements.

Eligible Medicare Plan Types

  • Standalone Prescription Drug Plans (PDPs).
  • Medicare Advantage Prescription Drug Plans (MA-PD).
  • HMOs, HMOPOS, Local PPOs, and Regional PPOs.
  • Special Needs Plans (SNPs).
  • Employer/Union Group Waiver Plans (EGWPs).
  • Limited Income Newly Eligible Transition (LI NET) Program.
  • Dually eligible beneficiaries enrolled in qualifying Part D plans.

Plans Generally Not Eligible

  • Private Fee-for-Service Plans.
  • Section 1876 Cost Contract Plans.
  • Section 1833 Health Care Prepayment Plans.
  • PACE Organizations.
  • Fallback Plans.
  • Religious Fraternal Benefit Plans.
Important: Eligibility requires enrollment in an eligible Medicare Part D plan and satisfaction of CMS clinical criteria and prior authorization requirements. Coverage is not guaranteed.

What Drugs Are Available?

At this time, for the purposes of the Medicare GLP-1 Bridge, an eligible GLP-1 drug is any of the following products when used to reduce excess body weight and maintain weight reduction: Foundayo®, Wegovy® injection and tablets, and Zepbound® KwikPen®.

Foundayo®

Included following FDA approval.

Wegovy®

Wegovy® injection pens and Wegovy® tablets are included.

Zepbound® KwikPen®

Only the KwikPen® formulation is included.

Note: This was updated on April 6, 2026, to include Foundayo® following FDA approval and to clarify that only the KwikPen® formulation of Zepbound® is included.

How to Obtain GLP-1 Drugs Through the Bridge

To access GLP-1 medications via the Medicare GLP-1 Bridge, an eligible beneficiary must have a medical provider submit a prior authorization request and a prescription for an eligible GLP-1 drug for a use covered under the demonstration.

1

Provider Visit

A medical provider determines whether the patient qualifies.

2

Prescription

The provider submits a prescription for an eligible GLP-1 drug.

3

Prior Authorization

The provider submits the Medicare GLP-1 Bridge prior authorization.

4

Plan Review

The request is reviewed according to Bridge Program criteria.

  • Prior authorization requests will be accepted electronically or by fax.
  • CMS strongly encourages providers to submit prior authorization electronically.
  • Providers do not need to take any action at this time.
  • CMS will provide additional information in June 2026.
  • Prior authorization requests will not be accepted or processed before July 1, 2026.
Important: Beginning July 1, 2026, a provider may submit a prescription to a pharmacy and will receive a request to complete prior authorization.