WASHINGTON — Millions of eligible Medicare beneficiaries can begin receiving certain prescription weight-loss medications for a fixed $50 monthly copayment starting Wednesday under a new federal pilot program that significantly expands access to obesity treatment while testing the program's long-term costs and health outcomes.
The U.S. Centers for Medicare & Medicaid Services (CMS) launched the Medicare GLP-1 Bridge on July 1, allowing qualifying beneficiaries enrolled in Medicare Part D prescription drug coverage to obtain approved glucagon-like peptide-1 (GLP-1) medications used for weight management through a temporary demonstration scheduled to run until Dec. 31, 2027.
The initiative marks a major shift in Medicare policy. Under longstanding federal law, Medicare generally has not covered drugs prescribed solely for obesity, except when the medications were approved for treating other conditions such as Type 2 diabetes or certain cardiovascular diseases.
CMS said eligible beneficiaries can access covered medications, including Novo Nordisk's Wegovy and Eli Lilly's Zepbound KwikPen and Foundayo tablet, through a centralized claims and prior authorization system rather than the standard Part D benefit. Participants pay a flat $50 monthly copayment while Medicare covers the remaining cost under the demonstration.
According to CMS, beneficiaries must meet specified eligibility requirements, including body mass index thresholds and other clinical criteria where applicable, and prescriptions must be accompanied by physician certification that the drugs are being used alongside diet and physical activity. Individuals already receiving Medicare coverage for GLP-1 medicines for other approved medical conditions are not eligible for the new demonstration.
CMS said the demonstration is intended to evaluate whether broader access to weight-loss medications can improve health outcomes while providing evidence to guide future Medicare policy. The agency said it will collect data on utilization, costs and clinical outcomes during the program.
Healthcare providers welcomed broader access for many older adults who previously could not afford the medications but cautioned that implementation could face challenges. Physicians have raised concerns that older patients using GLP-1 therapies may require careful monitoring for muscle and bone loss, emphasizing that nutrition and resistance exercise remain important components of treatment. Some experts also warned of possible enrollment delays, pharmacy readiness issues and uncertainty over what will happen after the demonstration concludes in 2027.
The Medicare GLP-1 Bridge is available nationwide beginning July 1 while CMS continues evaluating the program's performance before determining future policy options.
