Your plan’s formulary names the medicines covered by that plan. With prior authorization, payment depends on getting the plan’s agreement first.
A question for your plan“Is this exact medicine covered for my health condition, and what has to be approved before I fill it?”
GLP-1 is a substance the body makes that affects appetite and blood sugar.
The ingredients semaglutide (in Ozempic and Wegovy) and tirzepatide (in Mounjaro and Zepbound) copy GLP-1’s effects to treat diabetes or help control weight.
As of September 2026, people who qualify can get one month’s supply of certain weight-loss medicines for $50 through Medicare’s temporary GLP-1 Bridge.
July 1, 2026 is the program’s start date; its last day is December 31, 2027.
Part D is Medicare’s prescription-drug coverage.
As of September 2026, the Bridge is open to adults in separate Part D drug plans or certain Medicare Advantage plans with drug coverage.
Weight and health also matter: the rules use BMI, a number worked out using your height and weight.
A BMI of 35 or more can meet the weight rule; lower BMI numbers need one of the program’s specified health problems.
For example, a BMI of 27 or more with a past heart attack or stroke can meet that part of the rule.
The program checks these weight and health requirements using your situation when this type of treatment began.
Having type 2 diabetes rules out the Bridge; ask about coverage through your regular Part D plan instead.
If your Part D plan paid for GLP-1 medicine during 2026, that payment rules out using the Bridge during 2026.
A prescription and approval through the program are required.
The medicine must be used with an ongoing eating and activity plan.
Ask your health professional to check all the program’s health and plan requirements before relying on that price.
For medicines that regular Part D covers, your own payments are capped each year.
The $50 paid through the Bridge does not add to that yearly total, as of September 2026.