GLP-1s for $50 a Month? 14 Million Medicare Recipients May Be Eligible

• Federal officials announced the launch of a Medicare GLP-1 Bridge pilot program that reduces the cost of certain GLP-1 medications prescribed for weight loss.
• Under the program, Wegovy, Foundayo, and Zepbound KwikPens will cost $50 per month for eligible participants enrolled in Medicare Part D plans.
• The program begins on July 1 and continues through Dec. 31, 2027.

Some Medicare recipients will soon be able to purchase a limited number of GLP-1 weight loss drugs at a guaranteed price of $50 per month.

The Department of Health and Human Services (HHS) recently announced the formation of the Medicare GLP-1 Bridge pilot program, which begins on July 1 and lasts until December 31, 2027.

Under the pilot project, people enrolled in Medicare Part D who have been prescribed certain GLP-1 medications will be able to purchase those drugs for $50 per month.

It’s estimated that around 14 million people in the United States could be eligible under the pilot program.

Federal officials note that in the past, Medicare has not covered medications prescribed for weight loss. The pilot program lifts that restriction.

“These treatments are a major medical advancement, but too many seniors are currently unable to access them due to high cost,” Mehmet Oz, MD, the administrator of the Centers for Medicare and Medicaid Services, said in a statement. “The Medicare GLP-1 Bridge changes that by making these medications more affordable and accessible, while advancing our broader goal of helping Americans live healthier lives.”

The Medicare Bridge program follows the launch last year of a Trump Rx program to lower the cost of GLP-1 medications and other higher-cost drugs.

Which GLP-1s are covered and how much will they cost?

To be eligible for the Medicare GLP-1 Bridge program, a person must be at least 18 years old and be treated with the GLP-1 medication for weight loss and weight management.

The medications covered under the pilot program are:

• Wegovy (both injections and tablets)
• Zepbound (KwikPen)
• Foundayo

Zepbound single-use pens and vials will be not be covered.

To be prescribed these medications, a person must meet one of the following criteria:

• a body mass index (BMI) measurement of 35 or higher
• a BMI of 30 or higher with certain comorbid health conditions (i.e., heart failure, uncontrolled hypertension, or chronic kidney disease)
• a BMI of 27 or higher with other health risks (i.e., prediabetes or peripheral artery disease)

Medicare currently covers GLP-1 drugs prescribed for the treatment of certain conditions, such as type 2 diabetes and obstructive sleep apnea.

Recipients who utilize the bridge pilot program will not be eligible for this current coverage.

The $50 copays do not count toward the annual Part D deductible, which can be up to $615 for 2026. These payments also won’t count toward the yearly Part D out-of-pocket spending cap, which is $2,100 in 2026.

The cost of GLP-1 medications ranges from $149 per month from certain self-pay options to $1,349 per month.

Will Medicare GLP-1 Bridge actually lower costs?

Experts who spoke to Healthline said the Medicare pilot program will be helpful to a certain portion of the Medicare population.

“The biggest benefit of this program is increased access,” said Kanwar Kelley, MD, a specialist in otolaryngology head and neck surgery, obesity medicine, and lifestyle medicine, and the chief executive officer of Side Health in Orinda, CA.

“These medications are a breakthrough for clinically significant weight loss for the improvement of conditions that are related to obesity,” Kelley said.

“However, in my practice, there are individuals that simply cannot afford the cost of these medications, even when insurance pays some of the cost. The bridge program, if it reaches its goal, will provide a road for patients to get started on these medications and get the help they need,” he continued.

“I believe this is a viable option for Medicare patients seeking these types of medications,” said Mir Ali, MD, a bariatric surgeon, bariatric medicine specialist, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“The primary benefit is the significant reduction in out-of-pocket costs for Medicare beneficiaries,” he said.

Meredith Freed, a senior policy manager with KFF’s Program on Medicare Policy, agreed.

“Overall, the new GLP-1 Bridge is good news for people with Medicare who might benefit from taking GLP-1s to treat obesity but who have been unable to access these medications due to Medicare’s coverage restrictions or the relatively high cost of these drugs,” she said.

“At $50 per month, these drugs would be within reach for many more Medicare beneficiaries than they are today,” Freed added.

Possible drawbacks GLP-1 drug pilot program

The experts who spoke with Healthline expressed concerns about the program’s limitations.

One of the main issues, they said, is the project’s 18-month duration.

“With a time limit on the program, patients that are started on the medication may not be able to continue enjoying the discounted prices and may face increase costs or stopping the medication altogether,” said Kelley. “Stopping the medication abruptly may lead to weight regain.”

“This appears to be a temporary solution that requires the participation of insurance companies to be feasible,” said Ali. “A long-term solution may not be available for several years.”

Freed said the fact the $50 co-payments don’t count toward Medicare deductibles or out-of-pocket spending caps could pose some issues.

She added that the restriction on recipients who are already covered for other uses of GLP-1s could be problematic, but agreed the program’s time limit is a major concern.

“This raises the possibility that people could gain access to these medications in the second half of 2026 and in 2027, only to lose access to them in 2028,” Freed said.

Kevin Schulman, MD, a professor of medicine at Stanford University, said that the federal government will subsidize the medications covered under the bridge plan. He said Medicare officials will need to decide if this program is worth the expenditure.

“In the end, this program will provide an interesting real-life experiment assessing the benefit of improving access to GLP-1s on overall healthcare spending,” he said.

What to know about GLP-1 medications

GLP-1 medications work by suppressing a person’s appetite and managing their blood sugar levels.

They have been approved by federal regulators as treatments for weight management as well as type 2 diabetes. Some are administered as weekly injections, and others are taken daily as an oral tablet.

In addition to Wegovy, Zepbound, and Foundayo, newer GLP-1 medications include Ozempic, Rybelsus, and Mounjaro.

Research has indicated that GLP-1 medications may also be beneficial for improving heart health and cognition.

There are some common side effects that include:

• nausea
• dizziness
• headache
• fatigue
• diarrhea
• constipation
• bloating

Experts say it’s important for people using GLP-1 medications to understand that they need to adjust lifestyle factors, such as diet and exercise, to achieve and maintain weight loss.

“Even with GLP-1 medication, lifestyle modification remains the most important aspect to weight management,” said Kelley. “While the medications can really jump-start weight loss, changing habits is essential to maintaining those losses and remaining at a healthy weight. Nutrient-dense food choices, physical activity, strength training, and sleep are critical.”