Medicare GLP-1 Bridge Calculator
CMS is implementing a temporary $50/month copay cap for eligible Medicare Part D enrollees. Answer 5 questions to check if you qualify.
Part D is prescription drug coverage — it may be standalone or included in a Medicare Advantage plan.
Not sure? BMI = weight (lbs) ÷ height (in)² × 703
About the Medicare GLP-1 Bridge Program
What is the Bridge Program?
Starting July 1, 2026 through December 31, 2026, CMS is implementing a temporary $50/month copay cap for Medicare Part D beneficiaries who qualify for GLP-1 medications for obesity treatment. This "bridge" provides access while permanent Medicare coverage rules are finalized by Congress.
The program covers FDA-approved GLP-1 medications prescribed specifically for chronic weight management, including Wegovy (semaglutide) and Zepbound (tirzepatide).
Who Qualifies?
- Enrolled in a Medicare Part D prescription drug plan
- BMI ≥ 30 (obesity), OR BMI ≥ 27 with a documented weight-related comorbidity
- Prescription written specifically for chronic weight management
- Not currently receiving GLP-1 through another federal program (VA, FEHB)
Program Timeline
What to Tell Your Doctor
To access the $50 copay, your provider must write the prescription specifically for "chronic weight management" with the appropriate ICD-10 codes for obesity (E66.x). Use this script at your next appointment:
"I have Medicare Part D and I understand there's a new $50 copay bridge program for GLP-1 medications for obesity treatment starting July 1, 2026. Can you prescribe [medication] for chronic weight management so I can access this benefit through my Part D plan?"
Confirm your plan's formulary includes the medication before starting — some plans may require prior authorization even under the bridge program.