Medicare's New GLP-1 Bridge Program: Who Qualifies & the $50 Copay

MEDICARE MONDAY Episode 13 | August 3rd, 2026

Presenter:

Kylie Miller | Trusted Insurance Advisor at American Republic Insurance Services

In episode 13 of Medicare Monday, Kylie Miller from American Republic Insurance Services sits down to explain a new CMS GLP-1 Bridge program that can make certain weight-loss medications more affordable for some people on Medicare.

Kylie notes the program is a trial run through December 2027.

Drugs discussed in the segment include options such as Wegovy and Zepbound, and not every Medicare beneficiary qualifies.
Kylie walks us through the main qualifying rules of the new GLP-1 Bridge Program:

Individuals BMI over 30 plus qualifying health factors such as heart failure, uncontrolled hypertension, or chronic kidney disease.
Or a BMI over 27 with related health complications.

You must already have prescription drug coverage — a standalone Part D plan or a Medicare Advantage plan that includes Part D coverage.

You also have to be accepted into the Bridge program and go through prior authorization.

On cost:

• This new offering from CMS in 2026 has the copay set at a flat $50 per month.
• That $50 does not count toward your deductible or your max out-of-pocket.
• LIS / Extra Help also cannot be applied to that $50 GLP-1 copay.
  
  

Watch Episode 13 now for a plain-language look at the GLP-1 Bridge rules, the $50 copay, and who may be eligible before the 2027 trial window ends.

Questions about GLP-1 costs & Medicare? Contact us - We help from Quincy, Lincoln, to Taylorville & across Central Illinois.