Medicare to Test 18-Month GLP-1 Pilot for Weight Loss Drugs Starting July 2026

Medicare beneficiaries may be able to get a GLP-1 prescription for weight loss for a $50 monthly copayment starting in July 2026 under a new pilot program. The Medicare GLP-1 Bridge pilot program starts on July 1, 2026, and ends on December 31, 2027. NPR reported that the short-term pilot is intended to bridge the gap before a possible longer-term program in 2028.

The Trump administration proposed a two-step approach to expand coverage of GLP-1s for obesity in Medicare. Not enough insurers signed on for the voluntary longer-term plan by the April deadline. A recent study found the long-term program would have cost insurance companies billions of dollars in the first year, prompting the Centers for Medicare & Medicaid Services to extend the Bridge program to 18 months.

The pilot program covers the pill and injectable formulations of Wegovy, the KwikPen formulation of Zepbound, and the Foundayo pill. Eligibility for the program requires enrollment in a Medicare Part D plan, a body mass index of 27 or higher with a condition such as heart disease or prediabetes, or a BMI of 35 or higher which qualifies automatically.

A previous KFF analysis estimated that in 2020 close to 14 million Medicare beneficiaries were overweight or obese.

About 40% of American adults are clinically obese with a BMI of 30 or higher, according to the Centers for Disease Control and Prevention. The Bridge program requires prior authorization sent to a central system run by CMS contractor Humana. Doctors do not need to be enrolled as Medicare providers to write a prescription or submit a prior authorization request under the Bridge program.

Patients pay a flat $50 copayment at the pharmacy after approval under the Bridge program. The $50 copay does not count toward the Part D deductible or the $2,100 annual out-of-pocket cap on prescription drug costs. Even with discounts, current cash prices for the drugs typically range from $149 to $699 per month.

On TrumpRx, Wegovy injectables range in price from $199 for a lower dosage for the first two months to $399 for a higher dosage. On TrumpRx, the KwikPen formulation of Zepbound costs up to $699 per month. On TrumpRx, the daily Wegovy pill costs up to $299 at the highest dosages while Foundayo tops out at $349.

Most people who use these drugs will need a higher dose to maintain weight loss. The Bridge program offers a predictable $50 copayment that does not go up as dosages increase. About half of GLP-1 users say these drugs were difficult for them to afford, according to KFF polling, while a quarter of GLP-1 users said they were very difficult to afford.

Beneficiaries who receive the low-income subsidy, also known as Medicare Extra Help, cannot use that assistance for drugs covered by the GLP-1 Bridge program. "Fifty dollars a month sounds like a great deal compared to paying the discounted prices through TrumpRx and these other direct-to-consumer options, but it's a lot of money for somebody who's living on a $750-a-month Social Security check," said Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF.

If already taking a GLP-1 for Type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea, coverage continues through the regular Part D plan.

For existing GLP-1 weight loss users, prescribers must attest that clinical criteria were met when the medication was first started. Medicare has long been barred from covering weight loss treatments.