Medicare GLP-1 Bridge Program

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.

What medications are covered?

The Medicare GLP-1 Bridge currently includes certain formulations of Wegovy®, Zepbound®, and Foundayo® when prescribed for weight management. The list of covered medications may change during the program.

Do I need a prescription from my doctor?

Yes. You will need a prescription from a qualified healthcare provider for an eligible GLP-1 medication.

Is prior authorization required?

Yes. Your healthcare provider must submit a prior authorization request confirming that you meet the Medicare GLP-1 Bridge eligibility requirements. Your prescription can be filled through the program once the required approval is received.

What if I already take a GLP-1 medication?

You may still qualify. Eligibility is based in part on whether you met Medicare's clinical requirements when you first started GLP-1 therapy. Your healthcare provider can provide the necessary information when submitting your prior authorization.

Can the pharmacy help me determine if I qualify?

Yes! Our pharmacy team can help answer questions about the Medicare GLP-1 Bridge and your prescription. Your healthcare provider will need to determine whether you meet the clinical requirements and submit the required prior authorization.

What if I don't qualify?

If you do not qualify for the Medicare GLP-1 Bridge program, Valley Pharmacy can help you explore other options from self-pay to eligible manufacturer savings cards.

How do I get started?

Talk with your healthcare provider to determine whether a GLP-1 weight management medication may be appropriate for you. If qualified, have your provider send the prescription to Valley Pharmacy. We will contact you, process the paperwork and fill your prescription.

Who is Eligible?

You may qualify for the Medicare GLP-1 Bridge if you have Medicare Part D prescription drug coverage and meet the following requirements:

You are enrolled in Medicare
You have Part D or Part C (Medicare Advantage) with prescription drug coverage
You have a prescription for a GLP-1 weight loss medication
BMI of 35 or higher, or
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
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.

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:

BMI of 35 or higher, or
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
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.

What medications are covered?

Do I need a prescription from my doctor?

Yes. You will need a prescription from a qualified healthcare provider for an eligible GLP-1 medication.

Is prior authorization required?

What if I already take a GLP-1 medication?

Can the pharmacy help me determine if I qualify?

How do I get started?

Talk with your healthcare provider to determine whether a GLP-1 weight management medication may be appropriate for you. Your provider will need to prescribe an eligible medication and submit the required prior authorization. Contact us for more details.

How the Program Works

Beginning July 1, Medicare is offering a new program for eligible individuals seeking GLP-1 medications for weight loss.

The program is available to qualifying individuals enrolled in a Medicare Part D prescription drug plan or Medicare Advantage plan with drug coverage.

To participate, your healthcare provider must obtain prior approval for you. Once approved, eligible weight loss medications may be available for a $50 monthly copay.

Interested in learning more? Contact our pharmacy or speak with your healthcare provider to find out if you may qualify.

Want To Learn More?

Medicare's new GLP-1 weight loss medication program began July 1, 2026-December 31, 2027, and is available to eligible individuals with Medicare Part D or qualifying Medicare Advantage prescription drug coverage.

If you're interested in learning more about the program and whether you may qualify, please complete the form below. A member of our pharmacy team will contact you to discuss the next steps.