Starting July 1, 2026, Medicare Part D beneficiaries will be able to access GLP-1 medications through the Medicare GLP-1 Bridge — a short-term demonstration program offering eligible patients access to certain GLP-1 drugs at approximately $50 per month. The program runs through December 31, 2027.
How the Bridge Program Works
The Medicare GLP-1 Bridge is managed by CMS through a single central processor that handles prior authorization, claims adjudication, and payments to pharmacies. Unlike standard Part D coverage, this program operates as a demonstration — meaning it's designed to collect utilization data while expanding access.
The Bridge extends through 2027, giving CMS time to gather data on GLP-1 utilization before potentially implementing the broader BALANCE Model in Part D. The BALANCE Model's Medicare component has been indefinitely delayed, making the Bridge the only near-term pathway for seniors to access affordable GLP-1 medications through Medicare.
Who Qualifies
Eligibility is tied to your Part D enrollment and clinical criteria. You'll need a qualifying diagnosis — either type 2 diabetes or obesity (BMI 30+, or 27+ with weight-related comorbidities) — and a prescription from a licensed healthcare provider. The exact formulary of covered GLP-1 drugs will be specified by CMS.
What This Means for Cost Comparisons
At $50 per month, the Bridge program undercuts even the most affordable compounded GLP-1 options. But it only covers brand-name FDA-approved medications, meaning you'll be prescribed Wegovy, Zepbound, or potentially Foundayo — not compounded alternatives.
| Option | Monthly Cost | Medication Type | Who It's For |
|---|---|---|---|
| Medicare Bridge | ~$50/mo | Brand-name only | Medicare Part D enrollees |
| Compounded (telehealth) | $99–$199/mo | Compounded | Self-pay patients |
| Brand-name (retail) | $997–$1,349/mo | Brand-name | Insured/cash pay |
| Foundayo (self-pay) | $149–$399/mo | Brand-name oral | Self-pay, no injection |
For Patients Under 65
The Medicare Bridge doesn't apply to you, but affordable options still exist. Compounded GLP-1s through licensed telehealth providers remain available, and Foundayo's self-pay pricing starts at $149/month.
Sunlight $159/mo sema, $239/mo tirz · LegitScript certified. Flat pricing — $159 first month, $179 ongoing (semaglutide). No membership, free shipping, HSA/FSA.
⚕️ Compounded medications are not FDA-approved. They are prepared by licensed pharmacies under physician supervision.
GobyMeds $99/mo sema, $133/mo tirz · Direct-to-consumer telehealth. Semaglutide $99/mo bundle, tirzepatide $133/mo bundle. Code x7X72r saves $25.
⚕️ Compounded medications are not FDA-approved. They are prepared by licensed pharmacies under physician supervision.
Sesame Care From $99/visit · Prescribes FDA-approved brand-name medications only. Accepts insurance. No subscription lock-in.
Prescribes FDA-approved brand-name medications only.