GLP-1 Bridge Program
Transition Medical Weight Loss is excited to now welcome Medicare patients for eligible medical weight-loss visits.
For many years, Medicare patients seeking obesity treatment faced major barriers, especially when it came to accessing prescription medications for weight management. Our ability to accept Medicare helps make expert obesity care more accessible to patients throughout New Hampshire, Massachusetts, and beyond.
At the same time, another important Medicare change begins on July 1, 2026: the new Medicare GLP-1 Bridge Program.
This CMS program may help qualifying Medicare beneficiaries access certain GLP-1 medications for weight management at a predictable monthly cost.
What Is the Medicare GLP-1 Bridge Program?
The Medicare GLP-1 Bridge is a temporary Medicare program running from July 1, 2026 through December 31, 2027.
It gives eligible people with Medicare Part D prescription drug coverage access to certain GLP-1 medications for weight management at a flat $50 copay per monthly supply.
This is a major step forward for Medicare patients living with obesity, especially those who have been unable to afford medications such as Wegovy or Zepbound without coverage.
The program operates outside of the normal Part D drug benefit. This means the medication does not go through your usual Part D formulary process, your Part D deductible does not apply, and the $50 copay does not count toward your Part D out-of-pocket costs.
Which Medications Are Included?
The Medicare GLP-1 Bridge currently includes eligible prescriptions for:
- Wegovy injection
- Wegovy tablets
- Zepbound KwikPen
- Foundayo tablets
Please note that the single-dose Zepbound pen and Zepbound vial formulations are not included in the Bridge program.
Your clinician will help determine which medication option is medically appropriate based on your health history, goals, preferences, and eligibility.
Who May Qualify?
To qualify, you must be at least 18 years old, have Medicare Part D prescription drug coverage, and be seeking treatment with a GLP-1 medication for weight management.
This can include:
- Original Medicare with a standalone Part D prescription drug plan
- Medicare Advantage plans that include prescription drug coverage
- Certain Special Needs Plans
- Certain employer or union Medicare plans with prescription drug coverage
You must also meet Medicare’s BMI and medical criteria when starting GLP-1 treatment.
BMI 35 or Higher
You may qualify with a BMI of 35 or higher.
No additional qualifying health condition is required under this eligibility tier.
BMI 30 or Higher Plus a Qualifying Health Condition
You may qualify with a BMI of 30 or higher if you also have at least one qualifying health condition, including:
- Heart failure with preserved ejection fraction
- High blood pressure that is not controlled on two medications
- Chronic kidney disease, stage 3a or higher
BMI 27 or Higher Plus a Cardiometabolic Condition
You may qualify with a BMI of 27 or higher if you also have at least one qualifying cardiometabolic condition, including:
- Prediabetes
- Previous heart attack
- Previous stroke
- Symptomatic peripheral artery disease
Eligibility is based on your individual medical history, BMI, and Medicare requirements. Not every person with obesity will qualify, but many Medicare patients may now have an option that was not previously available.
Important Note for Patients With Diabetes, Sleep Apnea, or MASH
The Medicare GLP-1 Bridge is designed for GLP-1 treatment specifically for weight management.
Patients who have type 2 diabetes, moderate to severe obstructive sleep apnea, or noncirrhotic MASH may already be eligible for GLP-1 coverage through their regular Medicare Part D plan when the medication is prescribed for one of those covered medical indications.
During your visit, our team will review your medical history and determine the most appropriate coverage pathway.
How Can Transition Help?
At Transition Medical Weight Loss, we provide comprehensive obesity care that includes medical evaluation, nutrition support, activity guidance, ongoing follow-up, and medication management when appropriate.
For patients who may qualify for the Medicare GLP-1 Bridge, our team can:
- Review your medical history, BMI, medications, and qualifying conditions
- Confirm whether a GLP-1 medication is medically appropriate
- Help determine whether you meet the Medicare Bridge criteria
- Submit the required prescription and prior authorization request
- Coordinate ongoing visits focused on nutrition, physical activity, and medication management
- Help address medication questions, side effects, dose adjustments, and long-term treatment planning
Medicare requires ongoing nutrition and activity support alongside medication treatment. That is exactly how our program is designed.
How Much Will the Medication Cost?
For patients approved through the Medicare GLP-1 Bridge, the expected cost is:
$50 per monthly supply
This price is the same throughout the year under the program.
Because the program operates outside of the standard Part D drug benefit:
- Your Part D deductible does not apply
- The $50 copay does not count toward your Part D out-of-pocket costs
- Medicare Extra Help does not reduce the $50 copay
- Manufacturer coupons cannot be combined with the program
Your Medicare medical visits with Transition are separate from the medication copay. Depending on your Medicare coverage, supplemental coverage, or Medicare Advantage plan, you may have a copay, coinsurance, or deductible for office visits. Our team will help verify your benefits before your first appointment.
How Do I Get Started?
The first step is to schedule an appointment with our medical team.
During your visit, we will review your health history, BMI, current medications, and potential qualifying conditions. If a GLP-1 medication is appropriate and you meet Medicare’s criteria, we can submit the prescription and prior authorization request on your behalf.
Once approved, your pharmacy can typically dispense the medication after the claim is processed through the Medicare GLP-1 Bridge system.
Medicare Patients Are Welcome at Transition
Transition Medical Weight Loss is proud to now welcome Medicare patients for medical weight-loss care.
Whether you are interested in GLP-1 medication, nutrition support, a medically supervised program, or a long-term plan to improve your health, our team is here to help you understand your options.
Call us at (603) 685-0462 or book your first visit online to get started.
Important note: Coverage and eligibility are determined by Medicare and your individual medical history. Transition Medical Weight Loss cannot guarantee approval. The Medicare GLP-1 Bridge is a temporary program currently scheduled to run through December 31, 2027.