Medicare to Cover Select Weight-Loss Drugs for Two Years Starting July 2026 Under New Pilot

Some Medicare patients will gain access to GLP-1 medications prescribed solely for weight loss starting July 1 through the Medicare GLP-1 Bridge pilot program. Eligible beneficiaries enrolled in Part D plans will pay a $50 monthly copay for the drugs.

The program covers Eli Lilly's Foundayo daily pill and Zepbound KwikPen weekly injection as well as Novo Nordisk's Wegovy in both injection and pill forms.

It marks the first time Medicare will pay for obesity drugs without requiring a diagnosis such as diabetes or cardiovascular disease. The pilot runs from July 1, 2026, through December 31, 2027. After that date patients could lose coverage unless the Centers for Medicare & Medicaid Services extends the program or Congress changes the law, according to Juliette Cubanski, vice president and director of Medicare policy at KFF.

To qualify, a provider must submit a prior authorization request showing the GLP-1 is prescribed for weight loss. Patients must meet body mass index thresholds that include a BMI of at least 35, or a BMI of at least 30 with heart failure, uncontrolled hypertension or chronic kidney disease, or a BMI of at least 27 with prediabetes, prior heart attack or stroke, or symptomatic peripheral artery disease.

Patients already taking a GLP-1 under Medicare Part D for Type 2 diabetes or sleep apnea are not eligible.

The $50 copay does not count toward a patient's deductible or the $2,100 yearly out-of-pocket cap, and coupons or discounts cannot be applied. "Medicare is not changing the law right now," Cubanski said. " "The good news is they don't have to meet their deductible in order to qualify for the $50 copay," she added.