Coverage Update for Popular GLP-1 Medications
New this summer for patients with Medicare Part D is the Medicare GLP-1 Bridge program, which will expand access to GLP-1 medications used for weight loss to Medicare beneficiaries.
This program will start on July 1, 2026 and will allow patients who do not currently have access to these medications through the Part D benefit to get Foundayo tablets, Wegovy injection and tablets, and Zepbound multidose pen (not single dose pen) for $50 per month.
In order to be eligible for this, the patient needs to be enrolled in Medicare D, be prescribed the GLP-1 to reduce excess body weight and maintain weight reduction, and have one of the following:
- Body mass index (BMI) of at least 35
- BMI of at least 30 AND a diagnosis of one or more of the following: heart failure with preserved ejection fraction, uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg,despite concurrent treatment with two antihypertensive medications), or chronic kidney disease stage 3a or above
- BMI of at least 27 AND a diagnosis of one or more of the following: pre-diabetes, previous myocardial infarction, previous stroke, or symptomatic peripheral artery disease
These medications are available as a prescription, so talk to your healthcare provider if you are interested in taking a GLP-1. We expect there to be a lot of questions about this new program, so please call the staff at any Forward Pharmacy for assistance.
For patients without Medicare who do not have diabetes, but are looking for a GLP-1 for weight loss, the least expensive option is Wegovy tablets. This can be filled at a local pharmacy with a coupon the patient obtains from the manufacturer’s website.
Patients can expect to pay at most $149 per month for Wegovy 1.5mg, $199 per month for Wegovy 4mg, and $299 per month for Wegovy 9mg and 25mg.
For those looking for tirzepatide for weight loss, the least expensive option is Zepbound multidose pen. This can also be filled at a local pharmacy with a coupon the patient obtains from the manufacturer’s website. Patients can expect to pay at most $299 per month for Zepbound 2.5mg; $399 per month for Zepbound 5mg; $449 per month for Zepbound 7.5mg, 10mg, 12.5mg, and 15mg.