Medicare GLP-1 Bridge: New CMS Program for Certain Weight-Loss Drugs

The Centers for Medicare and Medicaid Services (CMS) is expanding access to certain GLP-1 medications for people with Medicare Part D through Medicare GLP-1 Bridge starting July 1, 2026. The program will continue through Dec. 31, 2027.

Medicare GLP-1 Bridge will operate outside of Medicare Part D plan coverage and use a central processor to manage prior authorization, claims processing, and pharmacy payment.

NOTE: This is a CMS-managed program. Highmark is sharing this information as a service to our members and our provider community.

Who is eligible for the Bridge program?

The Medicare GLP-1 Bridge is for patients who are not eligible to receive a GLP-1 drug through their Part D plan and do not have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease.

For more information, go here.

What GLP-1 Drugs will be available for the Bridge Program? Foundayo® (tablets), Wegovy® (injection and tablets), and Zepbound® (KwikPen® injection). 

What is the member cost for a 30-day supply of the selected GLP-1? Pharmacies will collect a $50 copay amount from the eligible beneficiary, and the central processor will process payment to the pharmacy.

Where do providers submit a prior authorization request for eligible patients?

Using this form, prior authorization requests should be submitted electronically at CoverMyMeds.com. Providers can also use this number 800-530-2404 to fax the form.