The Centers for Medicare & Medicaid Services (CMS) is launching the Medicare GLP-1 BRIDGE demonstration Program on Jul. 1, 2026, to expand access to GLP-1 medications for weight loss for Medicare members.
What’s the BRIDGE Program?
The Medicare GLP-1 BRIDGE Program is a temporary, transitional program designed to support access to weight management medications. It will run from Jul. 1, 2026 through Dec. 31, 2027.
How the program works
The Medicare GLP-1 BRIDGE Program will operate outside the Medicare Part D benefit, meaning Medicare Part D plans—including Priority Health—won’t cover, manage or process medications through BRIDGE. Instead, Humana has been assigned by CMS as a central processor to manage:
- Prior authorization
- Claims adjudication
- Pharmacy payment
Medications included in BRIDGE
The program includes the following GLP-1 medications for weight management:
- Wegovy® (all formulations)
- Foundayo® (all formulations)
- Zepbound® (KwikPen® only)
Medication availability is determined by CMS and may change during the program.
Patient eligibility
Medicare beneficiaries may qualify if they:
- Are enrolled in a Medicare Part D plan, and
- Meet prior authorization (PA) criteria, including:
- Use for weight management with ongoing lifestyle modification
- Age 18 and older
- Meet BMI and/or comorbidity requirements
Full PA criteria and additional information are available on the CMS BRIDGE Program website.
It’s important to note, if a GLP-1 medication is prescribed for a Part D-covered indication (e.g., cardiovascular risk reduction, obstructive sleep apnea), it will continue to be reviewed and managed by the member’s Part D plan.
Cost and coverage
- Traditional Medicare is the primary payer for covered medications under the BRIDGE Program
- Member cost share consists of a $50 copay per fill
- BRIDGE claims don’t count toward:
- Part D gross covered prescription drug costs (GCPDC)
- True out-of-pocket costs (TrOOP)
Resources
CMS has created the following resources for providers:
- Prescriber Fact Sheet: Key information for prescribers when referring patients to the Medicare GLP-1 BRIDGE program
- Pharmacy Fact Sheet: Guidance for pharmacies on billing and dispensing under the BRIDGE program
- Prior Authorization Form: An outline of clinical criteria for Medicare GLP-1 BRIDGE eligibility