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Medicare GLP-1 Bridge · Launches July 1, 2026

Do I Qualify for the
$50/Month Weight Loss Drug Program?

Answer a few quick questions to see if you may qualify for Wegovy, Zepbound, or Foundayo under the Medicare GLP-1 Bridge.

Free · Takes about 2 minutes · Nothing is stored or transmitted
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Step 1 of 6

Are you enrolled in Medicare?

The GLP-1 Bridge is open to Medicare beneficiaries — whether enrolled due to age (65+), disability, or ESRD.

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Step 1 of 6

Are you 18 or older?

The GLP-1 Bridge requires age 18 or older.

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Step 2 of 6

Do you have Medicare Part D coverage?

The GLP-1 Bridge runs through Part D prescription drug plans — including standalone PDPs and Medicare Advantage plans with drug coverage.

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Step 2 of 6

Not sure? Here's how to check

No problem — you can keep going and verify your coverage later. Here's where to look:

Check your separate prescription drug plan card (Part D isn't shown on the red, white & blue Medicare card), log in at Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). Drug coverage that's part of a Medicare Advantage plan counts — including Special Needs Plans (SNPs) and employer/union group waiver plans (EGWPs).
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Step 3 of 6

Has a doctor diagnosed you with any of these?

Type 2 diabetes, obstructive sleep apnea (OSA), or MASH (a liver condition). These determine which coverage pathway applies to you.

ℹ️ If you have one of these diagnoses, GLP-1 medications may already be covered through your regular Part D plan — you wouldn't use the Bridge program at all. That can be good news.
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Step 4 of 6

Have you ever taken a GLP-1 for weight management?

For example, Wegovy or Zepbound. Prior use does not disqualify you — eligibility is based on your situation when you first started therapy.

ℹ️ The Bridge covers Wegovy (semaglutide — injection or tablets), Zepbound (tirzepatide — KwikPen only; vials and single-dose pens aren't covered), and Foundayo (orforglipron — a daily oral tablet with no food or water restrictions). It does not cover Ozempic, Mounjaro, or Rybelsus — those carry diabetes indications and go through regular Part D instead.
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Step 5 of 6

Let's calculate your BMI

The program uses your BMI to set which criteria apply. Enter your current height and weight.

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Step 6 of 6

Do you have any of these specific diagnoses?

For your BMI range, CMS requires one of these exact diagnoses from a doctor.

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You Likely Qualify — Your Doctor Confirms

Based on your answers, you appear to meet the CMS criteria for the Medicare GLP-1 Bridge. Final eligibility is confirmed through a prior authorization your doctor submits.

Your Eligibility Summary

    What happens next
    • Your doctor submits the prior authorization — submissions open July 1, 2026. There's nothing you need to register for before then.
    • Once your first prescription is approved, monthly refills don't require a new prior authorization — unless you switch to a different covered medication.
    • Prescriptions are limited to 28- or 30-day supplies (90-day mail-order fills aren't available), and manufacturer savings cards or coupons can't be applied to Bridge prescriptions.
    • The Bridge requires ongoing lifestyle changes (structured nutrition and physical activity) that your doctor documents.
    • Available in all 50 states and U.S. territories, and runs through December 31, 2027.
    • A small number of Medicare plan types don't participate — an agent can confirm yours in minutes.
    ⚠️ Important — Know Your Costs
    • The $50/month copay is a separate cost outside your regular drug plan.
    • It does not count toward your Medicare Part D out-of-pocket spending limit, and does not apply to your plan deductible.
    • If you receive Extra Help (Low Income Subsidy), your copay is still $50/month — Extra Help does not reduce it.
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    Generate Your Letter & Bring It to Your Doctor

    Generate your free, personalized letter and bring it to your doctor — they submit the prior authorization that actually activates your coverage. It recaps your screening and lays out the exact CMS criteria they need to document.

    🔒 Free · Created on your device · Nothing is stored or sent

    Questions about whether your plan participates? A licensed Medicare agent can help — at no cost to you.

    📞 Call 866-764-3312
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    You May Not Qualify Right Now

    Based on your answers, one or more program requirements aren't met. There may still be options available to you.

    What We Found

      A licensed Medicare specialist can review your options — including plans that may work better for you.

      📞 Talk to Someone Free
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      You May Qualify — Worth Verifying

      Some of your answers need confirmation before eligibility is clear. Your doctor or a licensed agent can verify in a few minutes.

      What to Verify

        Good to know
        • If you do qualify, your doctor submits the prior authorization starting July 1, 2026 — nothing to do before then.
        • After the first approval, monthly refills don't need a new prior authorization (unless you switch medications).
        • Fills are limited to 28- or 30-day supplies, and manufacturer coupons can't be applied.
        • The Bridge requires documented ongoing nutrition and activity changes.
        • Available in all 50 states and U.S. territories, and runs through December 31, 2027.
        ⚠️ Important — Know Your Costs
        • The $50/month copay is a separate cost outside your regular drug plan.
        • It does not count toward your Medicare Part D out-of-pocket spending limit, and does not apply to your plan deductible.
        • If you receive Extra Help (Low Income Subsidy), your copay is still $50/month — Extra Help does not reduce it.
        📋

        Generate Your Letter & Bring It to Your Doctor

        Generate your free, personalized letter and bring it to your doctor — they confirm the open items and submit the prior authorization. It recaps your screening and lays out the exact CMS criteria they need to verify and document.

        🔒 Free · Created on your device · Nothing is stored or sent

        Want a licensed specialist to confirm your coverage first? They can help — completely free.

        📞 Call 866-764-3312
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        Good News — You May Already Have Coverage

        Because of your diagnosis, GLP-1 medications may already be covered under your regular Medicare Part D plan — you wouldn't need the Bridge program at all.

        What This Means

          What to do: Talk to your doctor about whether a GLP-1 is right for your condition. If they prescribe one for Type 2 diabetes, sleep apnea, or MASH, it goes through your regular Part D plan — plan rules like prior authorization or step therapy may apply, and your copay depends on your plan, not the Bridge's $50 cap. CMS rules make people with these diagnoses ineligible for the Bridge itself, because coverage already exists for them.

          A licensed agent can check whether your current Part D plan covers GLP-1s for your condition — and compare plans if it doesn't.

          📞 Call 866-764-3312
          The Pocket Protector · NPN 21126942 · 866-764-3312
          This tool is for informational purposes only and does not constitute medical or insurance advice. It is a pre-screening aid — final eligibility is determined through a prior authorization submitted by your doctor (using the official CMS form) beginning July 1, 2026, subject to CMS program rules and your plan's participation. The generated letter is a discussion aid for your doctor, not the official prior authorization form. The GLP-1 Bridge program is scheduled to run July 1, 2026 through December 31, 2027. For individual coverage questions, call 1-800-MEDICARE (1-800-633-4227).

          Not connected with or endorsed by the U.S. government or the federal Medicare program.