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Medicare Will Start Covering Weight-Loss Drugs on July 1 for the First Time
The temporary Bridge program will cap monthly copays at $50 and could reach millions of beneficiaries, CMS said.
- On July 1, the Centers for Medicare & Medicaid Services will launch the Medicare GLP-1 Bridge program, marking the first time Medicare will help pay for drugs prescribed solely for obesity.
- Federal law prohibits Medicare from covering weight-loss drugs, prompting the administration to conduct this temporary demonstration project following an agreement with Eli Lilly and Novo Nordisk to reduce costs.
- Eligible enrollees pay $50 monthly, though this copayment does not count toward annual out-of-pocket maximums; patients must have a BMI of 35 or higher, or lower BMI with specific health conditions, to qualify.
- Medicare beneficiaries who already receive GLP-1 drugs for diabetes or sleep apnea will continue using their regular Part D prescription drug coverage, as the pilot excludes those already covered.
- Running through the end of 2027, the Bridge program offers no clear path forward for coverage once it lapses; unless Congress changes the law or CMS issues an extension, patients may face higher cash prices.
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Survey: Most Seniors Unaware of Medicare GLP-1 Benefit
More than 8 in 10 older Americans are unaware that Medicare has launched a new program to provide eligible beneficiaries access to certain GLP-1 weight-loss drugs, according to a new survey released as the federal initiative begins.
·Washington, United States
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Coverage Details
Total News Sources13
Leaning Left4Leaning Right1Center7Last UpdatedBias Distribution59% Center
Bias Distribution
- 59% of the sources are Center
59% Center
L 33%
C 59%
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