The Bridge Program
What is it and who is it for?
By Manhattan Nutrition Clinic 10/09/2026
What is the Bridge Program?
The Bridge Program is a short-term demonstration, run by the Centers for Medicare & Medicaid, that will provide eligible Medicare Part D beneficiaries with access to specific GLP-1 drugs. This program runs from July 1, 2026, to December 31, 2027. The three covered medications are Wegovy, Zepbound, and Foundayo. These medications are only supplied in 28- to 30-day increments; Ozempic, Mounjaro, 90-day supplies, and pen needles are excluded from this program. The Medicare GLP-1 Bridge was designed to increase access to GLP-1s for beneficiaries who seek the drug solely to reduce excess body weight or maintain weight reduction.
To qualify for this program, beneficiaries must meet these requirements:
- You must be enrolled in Medicare Part D or a Medicare Advantage plan with prescription drug coverage.e
- You need a prescription for a covered drug strictly for weight loss, meeting standard Body Mass Index (BMI) thresholds:
- BMI of 35 or higher, or
- BMI between 30 and 35 with a weight-related comorbidity (such as high blood pressure or heart disease), or
- BMI between 27 and 30 with specific health risks like prediabetes
Exclusions from this program:
- You are not eligible if your current Part D plan already covers the medication for a condition like Type 2 diabetes
- Even if your specific plan did not choose to cover it for you
- Type 2 diabetes, moderate to severe obstructive sleep apnea (OSA), and noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver scarring (fibrosis) indications are eligible for Part D coverage
- Beneficiaries with these diagnoses are eligible to receive GLP-1s through their Part D plan and therefore are ineligible to receive them through the Medicare GLP-1 Bridge, even if they otherwise meet the Medicare GLP-1 Bridge clinical criteria
Rules regarding the program:
- Copay:
- A fixed $50 per 30-day supply
- Deductibles:
- This cost does not count toward your annual Part D deductibles or out-of-pocket maximums
- Coupons:
- Manufacturer discount cards and coupons cannot be used with this program
How to use the program:
As stated before, only those with a Medicare Part D supplement are eligible for this program. Before someone is deemed eligible to use the program, their provider must submit a prior authorization request stating that the beneficiary is prescribed the requested drug to reduce excess body weight and maintain weight reduction. This medication must be in combination with current and ongoing lifestyle modification, including structured nutrition and physical activity consistent with the applicable FDA-approved label. Potential beneficiaries must be at least eighteen (18) years of age and have a BMI greater than or equal to thirty-five (≥35) OR have a BMI greater than or equal to thirty (≥30) with a diagnosis of one
or more of the following: heart failure with preserved ejection fraction, uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg, despite concurrent treatment with two antihypertensive medications), chronic kidney disease stage 3a or above, OR have a BMI greater than or equal to twenty-seven (≥27) with a diagnosis of one or more of the following: pre-diabetes (as defined by American Diabetes Association guidelines), previous myocardial infarction, previous stroke, or symptomatic peripheral artery disease.
For more specific information, please reach out to your provider or a Medicare representative. This website has more general information.
Sources:
Manhattan Nutrition Clinic Blog
