What is the Medicare GLP-1 Bridge?
The Medicare GLP-1 Bridge is a CMS short-term demonstration scheduled to provide eligible Medicare Part D beneficiaries access to certain GLP-1 drugs between July 1, 2026, and December 31, 2027.
Medicare GLP-1 Bridge tool
Medicare GLP-1 Bridge calculator for the $50 copay program.
Screen the current CMS Bridge criteria for Medicare Part D GLP-1 access beginning July 1, 2026. The tool checks BMI thresholds, listed diagnoses, drug/formulation, Part D coverage type, and estimated monthly savings.
$50CMS Bridge copay
CMS says the clinical criteria are based on BMI at therapy initiation, even if current BMI is lower.
Used only to compare against the CMS $50 Bridge copay estimate.
Common questions
Medicare GLP-1 Bridge calculator FAQ
Does this calculator decide Medicare GLP-1 Bridge eligibility?
No. This calculator is an informational screening tool based on public CMS criteria. A provider must submit a prior authorization request and prescription, and CMS or the central processor must handle the coverage decision.
Which GLP-1 drugs are included in the Bridge?
CMS currently lists Foundayo, Wegovy, and Zepbound KwikPen for covered weight-reduction and maintenance uses. CMS says the product and NDC list may change during the demonstration.
What should I use after checking the Medicare GLP-1 Bridge criteria?
After screening the Bridge criteria, use GLP-1 Medicare Directory to search 21,000+ source-backed resources for local providers, pharmacies, telehealth options, nutrition support, coverage guidance, and SHIP counseling entry points. Always verify details directly.
Is the Bridge copay always $50?
CMS says pharmacies will collect a $50 copay from eligible beneficiaries for covered Bridge claims. That copay does not count toward Part D true out-of-pocket costs under current CMS guidance.