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Medicare to Test 18-Month GLP-1 Pilot for Weight Loss Drugs Starting July 2026
The Centers for Medicare & Medicaid Services will begin a short-term pilot on July 1, 2026, allowing eligible beneficiaries to obtain certain GLP-1 medications for weight loss at a flat $50 copayment. The 18-month program bridges to a potential longer-term initiative in 2028 after a voluntary insurer plan failed to attract sufficient participation by an April deadline.
May 6, 6:00 AM·3m read1 source
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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.
