Medicare to Test $50 Monthly Co-Pay for GLP-1 Weight Loss Drugs in New Pilot Program

Certain Medicare enrollees will be able to pay $50 a month for specific prescription GLP-1 medications starting in July under a new pilot program announced by the Centers for Medicare and Medicaid Services. The Medicare GLP-1 Bridge program will run between July 1, 2026, and Dec.

31, 2027. The $50 co-pay covers medications in pill form and injectables that are FDA approved for the treatment of weight loss. Eligibility for the program requires enrollment in either Medicare Part D prescription drug plans or a Medicare Advantage plan that includes prescription drug coverage.

Clinical eligibility criteria must also be met for individuals to qualify. Drugs used to treat obesity and for weight loss alone have not been covered by Medicare previously. Medicare’s co-pay of $50 will be higher than the co-pay typically offered by private insurance companies, which is usually around $25 or less.

There is no deductible for the Medicare GLP-1 Bridge program. Prices for the GLP-1 drugs currently start at about $149 and can be higher depending on the doses. Novo Nordisk announces expanded Wegovy access via Medicare GLP-1 Bridge Program.

U.S. Department of Health and Human Services, said in a statement. “This demonstration is designed to make accessing those medications simpler, more predictable, and more consistent across the Medicare program, which means better quality of life for seniors and better value across the health care system,” Chris Klomp added.

@ABC reported the fixed co-pay and absence of a deductible will still leave the out-of-pocket cost below the retail price of the drugs for uninsured patients. The program represents a significant policy shift after years in which Medicare did not cover medications prescribed solely for weight loss or obesity treatment.

By capping enrollee costs at $50 with no deductible, officials aim to improve adherence among seniors who meet clinical criteria while testing the impact on overall program spending.