Medicare Will Now Cover Weight Loss Drugs Like Wegovy and Zepbound, But Only for 18 Months

Millions of older Americans just got a new option for tackling obesity. It comes with a price tag most people can actually afford.

Starting July 1, 2026, Medicare will cover certain GLP-1 weight loss drugs through a new program called the Medicare GLP-1 Bridge. Eligible beneficiaries pay a flat $50 a month, a cost that’s a fraction of what these drugs normally run without coverage.

This marks a real shift. Medicare has never covered obesity drugs before. Federal law specifically excluded weight loss medications from Part D coverage, treating them more like lifestyle drugs than medical necessities. Now, at least temporarily, that’s changing.

Three drugs made the list. They include Wegovy in both injectable and pill forms, the Zepbound KwikPen, and Foundayo tablets. Novo Nordisk makes Wegovy, which relies on semaglutide to help patients lose weight. Eli Lilly makes Zepbound, and it works a bit differently, since it targets two hormone receptors instead of one.

All three still require a prescription. Patients can’t simply walk into a pharmacy and buy them. Providers must also submit prior authorization paperwork before anyone can access the drugs.

Not everyone with Medicare will qualify. First, you need Part D coverage. After that, you have to meet specific health criteria to move forward.

Generally, eligibility requires a BMI of 27 or higher and at least one related health condition, such as high blood pressure or heart failure. If you already receive a GLP-1 drug through Part D for something else, like type 2 diabetes, sleep apnea, or fatty liver disease, you won’t qualify separately under the Bridge program. Your doctor will also need to confirm the prescription is specifically for weight management, not for another condition, when submitting the paperwork.

The flat $50 fee sounds simple, and in some ways it is. Still, it works differently than typical Medicare drug costs. That $50 won’t count toward your Part D deductible. It also won’t apply toward the $2,100 annual out-of-pocket cap. Beneficiaries who rely on Extra Help, the low-income subsidy program, can’t use that assistance here either. For people used to paying just a few dollars per prescription, $50 might still feel like a real stretch.

A recent Kaiser Family Foundation analysis estimated that roughly 3.8 million Medicare beneficiaries meet the full eligibility requirements, based on 2023 claims data. That’s a substantial number of people, and the price tag reflects it. Federal spending on the program could reach between $1.3 billion and $3.3 billion, depending on how many eligible people sign up and how long they stay on treatment.

Here’s the part that worries some doctors and patient advocates: this coverage won’t last forever. CMS originally designed the Bridge program as a six-month stopgap. The plan was to hand things off to a bigger program called BALANCE in 2027, which would have shifted more of the cost burden onto private insurers.

However, insurers didn’t sign on in the numbers CMS expected. So in April 2026, the agency postponed BALANCE indefinitely and extended the Bridge program to 18 months instead. That leaves a real question mark hanging over what happens after December 2027. Unless CMS extends coverage again, or Congress changes the underlying law, beneficiaries could lose access to this pricing once the program winds down.

That’s not a minor concern. Research consistently shows that many patients regain weight after stopping GLP-1 medications. Some physicians and advocacy groups have pointed out that treating obesity this way, with coverage that simply disappears after a set period, wouldn’t happen for most other chronic conditions.

If you’re on Medicare and think you might qualify, start by talking to your doctor. They can walk you through the criteria and help submit the necessary paperwork. You can also check your eligibility directly through Medicare.gov, or call 1-800-MEDICARE for more information.

Since this program is still a demonstration, the rules could shift as CMS gathers more data. It’s worth staying in close contact with your provider about any changes down the road.