For many years, Medicare was not allowed to pay for medicines that were only for losing weight. However, this rule will change on July 1, 2026. The government is starting a special program called the Medicare GLP-1 Bridge. This program will let eligible people get these popular weight-loss treatments for a fixed price of $50 per month.
These medicines, scientifically called glucagon-like peptide-1 receptor agonists, were first made to help people with type 2 diabetes. Later, doctors found they also help reduce appetite and slow digestion, making them effective for weight loss. To make this possible, the government agreed with drug companies Eli Lilly and Novo Nordisk. The companies will sell the drugs to the government for $245 per month. Patients can choose from different versions like Wegovy, Zepbound, and Foundayo. Without insurance, these can cost between $149 and $699 each month.
Dr. Mehmet Oz from the Centers for Medicare & Medicaid Services called these treatments a big medical advancement. He said that the high cost prevented many older adults from accessing them. This new program aims to make them more affordable and encourage healthier lifestyles.
Initially, a different plan called BALANCE was planned, but insurance companies were worried about the costs. Because they did not join, the BALANCE project was stopped. The government then extended the temporary Bridge program to 18 months. It will not use the usual Medicare Part D system. Private plans have no financial risk, and a federal processor will handle payments. The program will be available nationwide, but doctors can only start the necessary paperwork on July 1, 2026. Eligibility requires being at least 18, having a Part D plan, and a BMI of 35 or higher, or a BMI between 27 and 35 with other health issues. Some conditions, like fatty liver disease or type 2 diabetes, can disqualify patients. The $50 monthly fee does not count towards yearly spending limits or deductibles.