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Medicare GLP-1 Bridge: $50 Wegovy, Zepbound & Foundayo (2026–2027)

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Quick answer: From July 1, 2026 to December 31, 2027, Medicare covers Wegovy, the Wegovy pill, Foundayo and the Zepbound KwikPen for weight management at a flat $50 per fill through the Medicare GLP-1 Bridge. You need Part D coverage and a qualifying BMI (35+, or 27–30+ with certain conditions).
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What the Medicare GLP-1 Bridge covers

Item Details
Dates July 1, 2026 through December 31, 2027 (extended from an original end date of December 31, 2026)
Cost to you $50 per fill, any dose. The Part D deductible doesn’t apply, and the $50 doesn’t count toward the $2,100 Part D out-of-pocket cap. Extra Help and coupons can’t lower it.
Covered drugs Wegovy (injection and pill), Foundayo, and the Zepbound KwikPen. Zepbound vials and single-dose pens are not included.
Who can enroll Adults 18+ with a standalone Part D plan or a Medicare Advantage plan with drug coverage who meet the health criteria below
Supply 28- or 30-day fills

Who qualifies

Your BMI and conditions are judged as of when you first started the medication:

  • BMI 35 or higher, on its own; or
  • BMI 30 or higher plus heart failure with preserved ejection fraction, uncontrolled high blood pressure despite two medications, or chronic kidney disease stage 3a or higher; or
  • BMI 27 or higher plus prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease.

People taking a GLP-1 for type 2 diabetes, moderate-to-severe sleep apnea or MASH, or who already get one through their Part D plan, stay in their regular Part D coverage at that plan’s price.

How to get it

  1. Check your eligibility at Medicare.gov/glp1bridge or call 1-800-MEDICARE.
  2. See a prescriber (in person or telehealth). They don’t need to be enrolled in Medicare. They send the prescription with an obesity diagnosis code and the note “SEND TO BRIDGE FOR WEIGHT MANAGEMENT.”
  3. Prior authorization is handled centrally by Humana for CMS, outside your Part D plan; decisions typically come within 72 hours.
  4. If you’re denied, there is no formal appeal, but your prescriber can resubmit with more information.

What happens after 2027?

The Bridge is scheduled to end December 31, 2027. CMS has said its longer-term BALANCE model will not start in Medicare in 2027 and has not set a new date, so coverage after 2027 is uncertain. Watch for updates from Medicare.

Track your results while you have coverage: a DEXA body composition scan before you start and every few months shows whether you’re losing fat or muscle, which matters more as we age.

Track fat vs. muscleBook a DEXA body composition scan near you.Paying cash? Start onlineZyndio’s physicians review your scan before anything is prescribed.Find a GLP-1 clinic near youCompare clinics in all 50 states.

Common questions

Does Medicare cover Wegovy or Zepbound in 2026?

Yes, for people who qualify. From July 1, 2026 through December 31, 2027, the Medicare GLP-1 Bridge covers Wegovy (injection and pill), Foundayo and the Zepbound KwikPen for weight management for a $50 copay per fill.

What BMI do I need for the Medicare GLP-1 Bridge?

A BMI of 35 or higher on its own; 30 or higher with heart failure with preserved ejection fraction, uncontrolled high blood pressure or stage 3a+ kidney disease; or 27 or higher with prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease.

Does Extra Help lower the $50 copay?

No. The $50 Bridge copay is flat; Extra Help and manufacturer coupons can’t be applied, and it doesn’t count toward the Part D out-of-pocket cap.

Is Medicare Advantage included?

Yes, if your Medicare Advantage plan includes Part D drug coverage. You also qualify with a standalone Part D plan.

Sources

Coverage rules change often and differ by plan. This guide summarizes public sources as of October 27, 2026 and is not insurance, legal or medical advice. Always confirm with your plan, your state Medicaid agency or Medicare (1-800-MEDICARE).