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Medicare GLP-1 Bridge: Wegovy, Zepbound or Foundayo for $50 a month

Checked October 19, 2026 on Medicare.gov and CMS.gov. Rules can change. Confirm with Medicare before you rely on them.

What is covered

• Wegovy: injection and tablets.
• Zepbound: KwikPen only. Single-dose vials and single-dose pens are not covered.
• Foundayo: tablets.

Only for weight management. Pen needles are not covered.

Who qualifies

You must be 18 or older, have Medicare drug coverage through an eligible plan, and meet one of these, measured when you started the medication:

• A BMI of 35 or higher.
• A BMI of 30 or higher, plus heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease stage 3a or higher.
• A BMI of 27 or higher, plus prediabetes, a previous heart attack or stroke, or peripheral artery disease with symptoms.

Already taking a GLP-1? You may still qualify. Your prescriber confirms that you met the criteria when you first started, even if that was before July 2026.

Eligible plans: stand-alone Part D plans, Medicare Advantage plans with drug coverage (HMO and PPO), Special Needs Plans, employer or union group plans, and LI NET. Private fee-for-service, cost plans and PACE are not eligible, unless you also have a stand-alone Part D plan.

When the Bridge does not apply

• You have type 2 diabetes, moderate to severe sleep apnea, or fatty liver disease (MASH). Your regular Part D plan may cover a GLP-1 for these instead.
• The GLP-1 is prescribed to lower the risk of heart attack and stroke. That goes through your Part D plan.
• Your Part D plan already covers your GLP-1.

How to get it, step by step

1. Talk to your prescriber about whether you meet the criteria. They do not need to be enrolled in Medicare.
2. Your prescriber sends the prescription to your pharmacy. Medicare asks them to certify that you use the medication with a diet and exercise program.
3. The pharmacy sends the claim to the Bridge. If a prior authorization is needed, the pharmacy asks your prescriber, usually within 24 to 72 hours.
4. You get a letter with the decision. There is no appeal, but your prescriber can send a corrected form.
5. Pay $50 at the pharmacy for each one-month supply (28 or 30 days, depending on the medication).

The approval lasts until December 31, 2027, including refills and dose changes, unless you switch to a different GLP-1.

What the $50 does not do

• It does not count toward your Part D deductible or your yearly out-of-pocket limit.
• Extra Help (the low-income subsidy) cannot lower it.
• It cannot be spread out with the Medicare Prescription Payment Plan.
• It does not show on your Part D Explanation of Benefits.

$50 compared with paying cash

With the Bridge, each covered medication is $50 a month at any dose. Without it, the self-pay prices are:

Over a year, that is 12 or 13 copays, depending on whether a fill lasts 28 or 30 days. See all self-pay prices by dose.

On LillyDirect vials? The Bridge covers the Zepbound KwikPen, not vials. Ask your prescriber whether a KwikPen prescription is right for you.

It is temporary

CMS calls the Bridge a short-term demonstration that ends December 31, 2027. What comes after has not been decided. We will update this page when CMS announces it.

Free help

• 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, for eligibility and prior authorization questions.
• Your State Health Insurance Assistance Program (SHIP) gives free, one-on-one Medicare counseling.

Sources

• Medicare.gov: Weight loss drugs (GLP-1 Bridge)
• CMS: Medicare GLP-1 Bridge
• CMS: Information for providers

Price information only, not medical advice. Which medication and dose is right for you is a decision with your prescriber. Wayby is independent: we sell no medication and earn nothing from these links.