Does Medicare cover weight-loss drugs like Wegovy and Zepbound?

Which weight-loss drugs does Medicare cover?

Starting July 1, 2026, Medicare covers three GLP-1 drugs under the Medicare GLP-1 Bridge program. Medicare.gov describes the Bridge as a temporary program, available nationwide, including in all states and U.S. territories, to certain people with Medicare drug coverage (Part D). Outside the Bridge, CMS's Part D rules exclude drugs from Medicare drug coverage (Part D) when they're used for weight loss, even for a noncosmetic purpose like morbid obesity.

• Foundayo (tablet)
• Wegovy (injection or tablet)
• Zepbound, KwikPen only: the program doesn't cover single-dose Zepbound vials or pens

Who qualifies for the Medicare GLP-1 Bridge?

You may qualify if you have Medicare drug coverage (Part D), you're 18 or older, and you meet one of these requirements when you start GLP-1 therapy:

• A body mass index (BMI) of 35 or higher.
• A BMI of 30 or higher and at least one of these conditions: diastolic heart failure (also called heart failure with preserved ejection fraction), uncontrolled high blood pressure (hypertension), or chronic kidney disease at stage 3a or higher.
• A BMI of 27 or higher and at least one of these conditions: prediabetes, a previous heart attack (myocardial infarction) or stroke, or blocked arteries in your legs or arms (peripheral artery disease) with symptoms.

Who isn't eligible for the GLP-1 Bridge?

You aren't eligible for the Medicare GLP-1 Bridge if your Medicare Part D plan already covers your GLP-1 drug, or if you have type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease. Medicare.gov says a Part D plan might cover a GLP-1 drug for those three conditions, so contact your plan.

Medicare's GLP-1 Bridge fact sheet says that if you've been using a GLP-1 drug paid for by your Medicare drug plan for any reason, you keep getting it through your plan. For this rule, GLP-1 drugs are products with the active ingredients semaglutide, tirzepatide, orforglipron, dulaglutide or liraglutide. The fact sheet also says you aren't eligible if your only Medicare coverage is through certain special plan types, like private fee-for-service plans, cost contract plans or a PACE organization.

If you have Medicare without drug coverage, Medicare.gov says you can sign up for a Medicare drug plan at certain times, and you may become eligible for the Bridge once you have drug coverage; see when you can join a drug plan. Drug discount cards aren't creditable coverage, and what you pay with one instead of your Medicare plan doesn't count toward your Medicare deductible or out-of-pocket maximum.

Does a Medicare Advantage plan count as drug coverage for the GLP-1 Bridge?

Yes, if it's a Medicare Advantage coordinated care plan with drug coverage. Medicare.gov lists these kinds of Medicare drug coverage for the GLP-1 Bridge:

• A standalone Medicare drug plan (PDP)
• A Medicare Advantage coordinated care plan with drug coverage (MA-PD), including HMO, HMOPOS, and local and regional PPO plans
• A Special Needs Plan (SNP)
• An employer or union group waiver plan (EGWP)
• The Limited Income Newly Eligible Transition (LI NET) program

What do I pay for Wegovy or Zepbound under the GLP-1 Bridge?

You pay the pharmacy a $50 copayment for a one-month supply, which is 28 or 30 days depending on the drug. Medicare's fact sheet says the cost is the same no matter your income level.

Because a separate Medicare program covers the drug, not your regular drug coverage, the $50 copayment doesn't count toward your Medicare drug plan's yearly deductible or out-of-pocket limit, and it won't appear on your Part D Explanation of Benefits or on a Medicare Summary Notice. Extra Help can't lower the copayment, and you can't spread it across months with the Medicare Prescription Payment Plan.

How do I get a GLP-1 drug through Medicare?

Your doctor or other health care provider sends a prescription for a covered GLP-1 drug to the pharmacy and, when requested, completes a prior authorization. Your provider must certify that you're using the drug as part of a lifestyle program that focuses on diet and exercise.

Your pharmacy may ask for your Medicare Number or the last 4 digits of your Social Security Number to process the prescription. You'll get a letter in the mail telling you the drug is covered under the Medicare GLP-1 Bridge. Your prior authorization stays valid, including for refills and dose changes, through December 31, 2027, unless you change GLP-1 drugs. If you suspect fraud, call 1-800-MEDICARE (1-800-633-4227); TTY users can call 1-877-486-2048.