Medicare GLP‑1 Bridge Program: Eligibility, Costs, and Drug Details | iPharmaCenter
- Badari Andukuri
- Jun 25
- 3 min read
Eli Lilly is preparing to launch a new access route intended to help some Medicare beneficiaries obtain GLP-1-based obesity treatments. The Medicare GLP-1 Bridge program marks a notable change in how weight‑management medicines may be covered for older adults and other Part D enrollees.
What is the Medicare GLP-1 Bridge program?
The Medicare GLP-1 Bridge program is a time-limited initiative created by Eli Lilly to give a subset of Medicare Part D members lower-cost access to chronic weight-management therapies. It functions as an interim coverage pathway that, for the first time, allows broader Part D reimbursement for GLP‑1-based obesity medicines in eligible patients.
When will the program be available?
The Bridge program is scheduled to open on July 1, 2026, and is expected to remain in place through December 31, 2027. During this period, both newly treated and already treated patients who meet all criteria can participate.
How much will Foundayo and Zepbound cost under this pathway?
For those who qualify, either Foundayo or Zepbound can be obtained at a fixed out‑of‑pocket cost of 50 dollars per month under the Medicare GLP‑1 Bridge program.
Who can enroll in the Medicare GLP-1 Bridge program?
To be considered eligible at the start of therapy, patients must satisfy several conditions defined by the Centers for Medicare & Medicaid Services:
Age: At least 18 years old.
Coverage: Enrolled in an eligible Medicare Part D prescription drug plan.
Clinical use: Have a valid prescription for Foundayo or Zepbound for chronic weight management in combination with diet and physical activity changes.
BMI: Either a body mass index of 35 or higher, or a BMI of 27 or higher with a current or previous weight‑related medical condition.
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Who is not allowed to participate in Medicare GLP-1 Bridge program?
Certain groups are excluded from the program. Patients who already receive a GLP-1 medicine covered under their existing Part D plan cannot enroll. In addition, people with type 2 diabetes, moderate to severe obstructive sleep apnea, or fatty liver disease are not eligible, because these conditions are generally addressed under other Medicare coverage pathways.
How well do Foundayo and Zepbound work in adults aged 65 and older?
Data from clinical trials suggest clinically meaningful weight loss in older adults:
Foundayo: In a post‑hoc analysis of the Phase 3 ATTAIN‑1 trial in adults without type 2 diabetes, participants aged 65 and above who received the highest dose lost an average of 13 percent of their body weight. The program also reported improvements in measures such as blood pressure, waist circumference and certain cholesterol parameters.
Zepbound: In the 72‑week SURMOUNT‑1 study, more than half of adults on the 15 mg dose lost at least 20 percent of their body weight. Within a predefined subgroup of adults aged 65 and older, patients taking the lowest approved maintenance dose (5 mg) achieved an average weight loss of 14.1 percent.
Why does this program matter for people on Medicare?
Federal rules have traditionally limited Medicare’s ability to cover medicines used primarily for weight loss, leaving many older adults with obesity to pay out of pocket or go without pharmacologic treatment. With an estimated four in ten U.S. seniors living with obesity, this has represented a significant treatment gap.
By creating a specific coverage route within Part D for GLP-1-based obesity drugs, the Bridge program treats obesity more explicitly as a chronic disease that may need long‑term therapy. The experience with this temporary pathway is likely to inform policy discussions about whether and how Medicare should cover weight‑management medicines on a permanent basis.
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