What is the Medicare GLP-1 Bridge program?
Beginning July 1, Medicare is offering a new program for eligible individuals seeking GLP-1 medications for weight loss.
How The Program Works
The program is available to qualifying individuals enrolled in a Medicare Part D prescription drug plan or Medicare Advantage plan with drug coverage.
Who Is Eligible?
You may qualify for the Medicare GLP-1 Bridge if you have Medicare Part D prescription drug coverage and meet one of the following requirements:
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BMI of 35 or higher, or
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BMI of 30 or higher with certain qualifying health conditions, including uncontrolled high blood pressure, chronic kidney disease (stage 3a or higher), or certain types of heart failure, or
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BMI of 27 or higher with prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease.
Your healthcare provider will need to confirm that you meet Medicare's eligibility requirements and complete the required prior authorization.
Certain individuals who already have Medicare Part D coverage for a GLP-1 medication for another qualifying condition may not be eligible for this program.