Medicare 2026

Medicare's GLP-1 Bridge: What a $50 Copay for Wegovy, Zepbound and Foundayo Through 2027 Actually Means

For the first time, Medicare is offering a path to GLP-1 medications prescribed specifically for weight loss — but it comes with important fine print. The Medicare GLP-1 Bridge is a temporary CMS demonstration that runs from July 1, 2026 through December 31, 2027, and it sits outside your Part D plan even though you need Part D (or a Medicare Advantage plan with drug coverage) to use it. Here is a plain-English guide to how the Bridge works, who qualifies, and how it fits with the rest of your Medicare drug coverage.

What the Bridge covers and what it costs

The Bridge covers three medications prescribed for weight loss: Wegovy (injection or tablet), Zepbound in the KwikPen form only, and the Foundayo tablet. Zepbound's single-dose vials and single-dose pens are not included.

The cost at the pharmacy is a $50 copay for a one-month supply, defined as 28 or 30 days. The program does not allow 60- or 90-day fills. Your Part D deductible does not apply to this copay, and the $50 does not count toward either the deductible or the Part D annual out-of-pocket cap (which is $2,100 in 2026 and $2,400 in 2027).

Two things that normally help with drug costs do not help here: Extra Help (the low-income subsidy) does not reduce the $50, and manufacturer copay cards or discount programs cannot be stacked with the Bridge.

Who qualifies

To use the Bridge you need Medicare drug coverage — either a stand-alone Part D plan or a Medicare Advantage plan that includes drugs. Special Needs Plans and employer group plans count. Then you need to meet the clinical criteria that Medicare.gov lists for the demonstration:

• Age 18 or older, and
• A BMI of 35 or higher, or
• A BMI of 30 or higher with diastolic heart failure (heart failure with preserved ejection fraction), uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher, or
• A BMI of 27 or higher with prediabetes, a previous heart attack or stroke, or peripheral artery disease with symptoms.

The Bridge is specifically for weight-loss use. People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible through the Bridge — their Medicare drug plan should cover GLP-1 drugs to treat those conditions directly. Likewise, if you are already getting a GLP-1 through your Part D plan, you are not eligible for the Bridge.

How the prescription actually gets filled

The prior authorization for the Bridge is handled by a central processor set up for the program, not by your Part D plan. Your prescriber submits the request there. Once approved, the authorization is good through December 31, 2027, and it covers your refills and any dose changes along the way. The only time you would need a new authorization is if you switch to a different GLP-1 drug.

That central-processor design is what lets the $50 copay stay consistent regardless of which drug plan you have.

Where the Bridge fits in your overall Medicare picture

The Bridge is a narrow program. The rest of your Medicare coverage — doctor visits, hospital care, your regular prescriptions — keeps working the way it always has. A few general reminders as you look at 2027:

• Annual Enrollment for 2027 runs October 15 – December 7, 2026, with changes taking effect January 1, 2027.
• The Part D out-of-pocket cap rises from $2,100 in 2026 to $2,400 in 2027. The highest deductible a Part D plan can charge in 2027 is $700, though many plans charge less.
• The Part D base beneficiary premium for 2027 is $41.33. That national figure is used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.
• Social Security announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.
• The 2027 Part B standard premium and deductible, and the IRMAA income brackets, had not been announced at the time this was written. CMS typically releases those figures in the fall. Check Medicare.gov when they post.

If you have Medicaid or qualify for Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare paired with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated D-SNP in any month.

Original Medicare with Medigap, or Medicare Advantage?

The Bridge is available either way, as long as you have Part D drug coverage. The broader choice between Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) and Medicare Advantage comes down to trade-offs only you can weigh. Original Medicare with Medigap generally offers wider provider choice and predictable cost-sharing, with separate premiums for Medigap and Part D. Medicare Advantage plans often bundle drug coverage and extra benefits and use networks and prior authorization to manage costs. Neither is "better" in the abstract — it depends on your doctors, your medications, your budget and how you like to use coverage.

Where to learn more

For official rules on Medicare drug coverage, enrollment windows, and the GLP-1 Bridge criteria, go to Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), available 24 hours a day, seven days a week. When the 2027 Part B figures and IRMAA brackets are released, they will be posted there too.