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GLP1 Clinics

Medicare GLP-1 Bridge Eligibility Checker

The Medicare GLP-1 Bridge now caps eligible patients' copay at a flat $50 a month. Answer five questions to see whether the criteria could apply to you or a family member. This tool is for education only. It does not decide your eligibility. Only your prescriber can confirm whether you qualify, and your prescriber (not you) submits the prior authorization.

This information is for educational purposes only and does not constitute medical advice. Consult a healthcare provider before starting any medication.

Medically reviewed by Dr. Golsa Gholampour, MD

Are you enrolled in a Medicare Part D plan?

Part D is Medicare's prescription drug coverage. You must be enrolled in Part D to use the Bridge, though the Bridge itself is processed separately, through a central processor.

If you have already started a GLP-1 and your weight has dropped since, enter your weight from when you started therapy. CMS uses your BMI at the time GLP-1 therapy was started.

Do you have any of these? (check all that apply)

These are typically covered under standard Part D, so they are handled outside the Bridge.

Have you been diagnosed with any of these? (check all that apply)

Nothing you enter is saved or sent anywhere. This runs entirely in your browser and is not medical advice.

Criteria source: CMS Medicare GLP-1 Bridge · Last verified July 1, 2026. GLP1 Clinics is not affiliated with Medicare or CMS.

Free guide

The Medicare GLP-1 Bridge is live

We'll email you a summary of the published eligibility criteria so you can discuss it with your prescriber. Flat $50/mo, separate from Part D, through 2027.

Frequently Asked Questions

What is the Medicare GLP-1 Bridge?
The Medicare GLP-1 Bridge is a CMS demonstration that caps eligible patients' copay at a flat $50 per month for covered GLP-1 medications. It runs July 1, 2026 through December 31, 2027 and is separate from the standard Medicare Part D benefit.
Who is eligible for the Bridge?
Eligibility is based on three BMI tiers for adults 18 and older: BMI 35 or higher; BMI 30 or higher with heart failure (HFpEF), uncontrolled hypertension, or CKD stage 3a or higher; or BMI 27 or higher with pre-diabetes, a prior heart attack, a prior stroke, or symptomatic peripheral artery disease. Patients whose GLP-1 is already coverable under Part D for type 2 diabetes, sleep apnea, or MASH use standard Part D instead of the Bridge.
Which medications does the Bridge cover?
All formulations of Wegovy (including tablets), Foundayo, and the Zepbound KwikPen only. Compounded GLP-1s are not covered, and Ozempic and Mounjaro remain diabetes-only.
Do I need to sign up for the Bridge?
There is no Part D plan opt-in and no separate beneficiary registration, but your prescriber submits a prior authorization. Prior authorizations are now being accepted.
How much does it cost?
A flat $50 per month, constant across the year. The copay sits outside Part D, so it does not apply to your deductible and does not count toward your out-of-pocket cap. If you normally get reduced copays through Extra Help (the Low-Income Subsidy), that subsidy does not apply to the Bridge, so your copay is still $50 per month.
Is Ozempic or Mounjaro covered by the Bridge?
No. Ozempic and Mounjaro remain diabetes-only and are not covered by the Bridge. The Bridge covers all forms of Wegovy (including tablets), Foundayo, and the Zepbound KwikPen only.
Is Foundayo (orforglipron) covered?
Yes. Foundayo, the oral GLP-1 orforglipron, was added to the Bridge's covered list on April 6, 2026, alongside Wegovy and the Zepbound KwikPen.
What if I have type 2 diabetes or sleep apnea?
Type 2 diabetes, sleep apnea, and MASH are covered under standard Medicare Part D, so they are handled outside the Bridge. The Bridge is for weight management in people who do not already have a Part D-coverable indication.
When can prior authorizations be submitted?
As of July 1, 2026, they are being accepted. Humana, which already runs Medicare's LI NET program, serves as the central processor for the Bridge, handling prior authorizations, claims, and pharmacy payments for this demonstration.
Is this checker an official eligibility determination?
No. It is an educational screen to help you understand the criteria. Only a licensed prescriber can confirm eligibility, and the prescriber submits the prior authorization.

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This site is for educational purposes only and is not medical advice. Always consult a healthcare provider before starting any medication. Full disclaimer