All articles
Medicare GLP-1 Bridge Program 2026
Reading time:
5 min
Mochi Bites
Get expert guidance and a personalized care plan designed around you.
How Much Do GLP-1s Cost With the Medicare Bridge Program?
Your copay is $50 per month. Whether you're getting the injection or the oral tablet, whether it's Wegovy, Zepbound, or Foundayo, the cost is $50.
However, this cost does NOT count toward your Part D deductible or out-of-pocket maximum.
For context, these medications can cost hundreds of dollars without insurance. The fact that Medicare negotiated a price and is covering the bulk of it is a significant change for beneficiaries.
What Happens After the Medicare GLP-1 Bridge Program Ends?
The Bridge runs through the end of 2027. Then what?
Medicare is hoping to launch the BALANCE Model as a more permanent solution for GLP-1 coverage. The good news: if you're already on a medication and it's working for you, you'll have a path forward. The slightly less certain part is that you'll need to enroll in a Medicare Part D plan that participates in BALANCE to keep your coverage.
How Can Mochi Help?
Step 1: Join Mochi. Chat with a licensed provider on the Mochi platform. Tell them you're interested in a GLP-1 medication. They'll assess whether it's right for you and whether you meet the clinical criteria for the Bridge.
Step 2: Check your eligibility. Your provider will confirm that you meet one of the three tiers and that your Medicare plan qualifies.
Step 3: Request a prior authorization. Before you can get the medication, Mochi will submit a prior authorization (PA) to Medicare. This just means getting approval from the program before you fill your prescription. Mochi handles the prior authorization process for you. We work with your provider to gather the information Medicare needs and submit it on your behalf.
Step 4: Get your prescription filled. Once you're approved, you'll pick up your medication at your local pharmacy for your $50 copay.
Ready to Get Started?
If you think the Bridge might be for you, the first step is simple: check your eligibility with Mochi.
If you are eligible for medication but Medicare doesn't approve, You may be eligible for other weight loss options, including compounded GLP-1 medications starting at just $99/month. Your provider can walk you through your options and help you choose what's best for you.
If you're not quite ready to dive into the Bridge but still interested in GLP-1 treatment, Mochi is here to help you access affordable treatment and medication options right now.
FAQs
Does Medicare cover GLP-1 medications for weight loss?
Yes. Starting July 1, 2026, the Medicare GLP-1 Bridge Program covers Wegovy, Foundayo, and Zepbound for weight loss. Beneficiaries who meet the eligibility criteria pay a $50/month copay.
Does Medicare cover Ozempic for weight loss?
No. Ozempic is FDA-approved for type 2 diabetes, not weight loss, so it is not included in the Medicare GLP-1 Bridge Program. However, Wegovy, which contains the same active ingredient (semaglutide), is covered under the Bridge for weight management.
Does Medicare cover Zepbound for weight loss?
Yes. The Zepbound KwikPen (tirzepatide) is covered under the Medicare GLP-1 Bridge Program for weight loss with a $50/month copay.
Does Medicare cover Wegovy for weight loss?
Yes. Both the oral and injectable versions of Wegovy are covered under the Bridge.
Does Medicare cover weight loss drugs?
Yes. Through the Medicare GLP-1 Bridge Program, Medicare Part D covers Wegovy, Foundayo, and Zepbound for weight loss starting July 1, 2026.
When does Medicare start covering weight loss drugs in 2026?
Medicare will cover weight loss drugs through the GLP-1 Bridge Program starting July 1, 2026. The program runs through December 31, 2027.
Will I be covered if my BMI was above 35 in the past but isn't now?
Eligible beneficiaries must meet the clinical criteria at the time of GLP-1 therapy initiation. This includes beneficiaries who initiated therapy prior to enrolling in Medicare Part D and/or prior to the July 1, 2026 launch. For example, if a beneficiary initiated GLP-1 therapy in September 2024 with a BMI of 37 and has a BMI of 34 at the time of a July 2026 prior authorization request, the prescribing provider should attest that the beneficiary met the BMI ≥35 criterion at the time therapy was initiated.
What is the Medicare GLP-1 Bridge Program?
The Medicare GLP-1 Bridge Program is an 18-month temporary program (July 2026 through December 2027) that allows Medicare Part D beneficiaries to access GLP-1 medications for weight loss at a $50/month copay. It serves as a bridge before Medicare's permanent BALANCE Model launches in 2028.
Disclaimer: This article is for educational purposes only and is not medical advice. Individual results are not guaranteed and may vary from person to person. Always consult your healthcare provider about your specific situation. Prescription medications require a provider's prescription. Compounded medications are not approved or evaluated by the FDA for safety, effectiveness, or quality. Program details are subject to change. Confirm current terms with Medicare or your Part D plan. All professional medical services through Mochi are provided by licensed physicians and clinicians affiliated with independently owned and operated professional practices. Mochi Health Corp. provides administrative and technology services to affiliated medical practices it supports, and does not provide any professional medical services itself.
Share this post
Mochi Bites
More articles
Read next
For iOS & Android
