Medicare Launched a New Program Last Month That Could Lead to Big Savings for Seniors
Key Points
Medicare launched a GLP-1 Bridge Program last month, which runs through Dec. 31, 2027.
Qualifying seniors will be able to get GLP-1s for weight loss for $50 per month.
You must meet specific health and insurance criteria to qualify.
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It's hard to overstate how much the rising popularity of GLP-1s has shaped healthcare over the last few years. Demand for these drugs has grown sharply, but access remains a challenge for many, due to limited insurance coverage.
Until recently, seniors on Medicare had to pay out of pocket if they wanted to try these drugs for weight loss. But the new GLP-1 Bridge Program launched last month is changing that, and the effects on seniors' health and wallets could be significant.
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How the Medicare GLP-1 Bridge Program works
The Medicare GLP-1 Bridge Program gives qualifying Medicare beneficiaries access to select GLP-1s for weight loss from July 1, 2026, to Dec. 31, 2027, for $50 per month. Currently, the covered drugs include:
- Foundayo (tablet)
- Wegovy (injection or tablet)
- Zepbound (KwikPen only)
To qualify for this, you'll need a prescription from your doctor, and you'll also have to meet the following criteria:
- You have a Medicare Part D plan or a Medicare Advantage plan with prescription drug coverage.
- You're not eligible to receive a GLP-1 through your Medicare drug plan.
- You don't have type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease.
- You're at least 18 or older, and one of the following is true:
- You have a body mass index (BMI) of 35 or higher.
- Your BMI is 30 or higher, and you have certain types of heart failure, high blood pressure that's hard to control, or chronic kidney disease (stage 3a or above).
- Your BMI is 27 or higher, and you have prediabetes, or you've had a heart attack, stroke, or blocked arteries in your legs or arms.
Your doctor will also have to submit a prior authorization form to Medicare.
The savings could be pretty significant
Paying for GLP-1s out of pocket can cost hundreds of dollars per month, so the GLP-1 Bridge Program is an option worth exploring if you're interested in these medications. Because this program is separate from your Part D plan, the monthly co-pays won't count toward your Part D out-of-pocket maximum for the year, but the predictable $50 payments can still help keep your retirement healthcare costs manageable.
If the medications help you lose weight, this could also decrease your risk of other costly health conditions as you age. That could help you stretch your savings even further, which is useful if you're worried about running out of money early.
Start by checking with your doctor to see if you qualify for the GLP-1 Bridge Program, and reach out to the Centers for Medicare & Medicaid Services if you have any questions about how the program works.
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