What Does the Medicare GLP-1 Bridge Program’s $50 Copay Mean?
GLP-1 medications for weight loss can be expensive, so a $50 monthly medication copay may sound like a big change. The Medicare GLP-1 Bridge Program is a temporary federal program that gives eligible Medicare beneficiaries access to certain GLP-1 medications for weight loss for $50 per month. But that doesn't mean all your health care costs will be $50.
At a glance: What the $50 means
- The $50 copay is for a one-month supply of an eligible medication through the Bridge Program.
- The copay is separate from your regular Medicare Part D benefit.
- Your other Medicare premiums and health care expenses may still apply.
- The $50 copay doesn't count toward your Part D deductible or annual out-of-pocket drug costs.
What does the $50 monthly copay cover?
The $50 copay applies to certain covered GLP-1 medications furnished through the Bridge Program. Currently, these include Foundayo tablets, Wegovy injections or tablets, and Zepbound KwikPen. Other formulations, including single-dose Zepbound pens and vials, aren't covered through the program.
What costs should you check? Use this checklist
| 🔘 The medication copay | If you're eligible, your cost for a covered medication through the Bridge Program is $50 for a one-month supply. |
| 🔘 Your Medicare premiums | Your regular Part B and Part D premiums, or other applicable plan premiums, don't go away because you use the Bridge Program. |
| 🔘 Your other health care expenses | Doctor visits, tests, other prescriptions, and other medical expenses may still cost you money. |
| 🔘 Your Part D deductible and out-of-pocket costs | The Bridge copay is outside the normal Part D payment process, so the $50 doesn't count toward your Part D deductible or annual out-of-pocket drug costs. |
| 🔘 Your current GLP-1 coverage | If your Medicare drug plan already covers your GLP-1 medication, you generally aren't eligible to receive it through the Bridge. Ask your plan about your existing coverage and costs. |
| 🔘 Your eligibility and prescription | The $50 copay isn't available to everyone. You must meet the program's requirements, have a covered prescription, and complete the required authorization process. |
What should you do next?
- Check your Medicare coverage and gather your health and medication history. These details can help you and your health care provider determine whether you may qualify.
- Complete the required steps with your provider. If you're eligible for Bridge, your provider must prescribe a covered GLP-1 medication and, when required, submit a prior authorization. They must also confirm that you're using the medication as part of a lifestyle program focused on diet and exercise.
- Watch for a coverage letter in the mail. You'll receive a letter letting you know whether your medication is covered through the Medicare GLP-1 Bridge Program. Your prior authorization generally remains valid through December 31, 2027, including for refills and dose changes, unless you switch GLP-1 medications.
- Fill your prescription at the pharmacy. Your pharmacy will process your prescription through the Bridge Program, and you may need to provide your Medicare Number of the last four digits of your Social Security number.
Understanding what the $50 monthly medication copay covers, and what other costs you may still pay, can feel overwhelming, but you don't have to figure it out alone. Visit Medicare.gov to learn more about the Medicare GLP-1 Bridge Program, covered medications, and what to expect.
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