Medicare GLP-1 Bridge Program

Important: This Program Is NOT Part of VillageCareMAX Plan Benefits

The GLP-1 Bridge Program is run directly by Medicare, not VillageCareMAX.
These medications are not covered under the VillageCareMAX prescription drug benefit when used only for weight loss.
The program has its own rules, approval process, and costs.
Any costs a Medicare recipient pays through this program does NOT count toward their plan deductible or out-of-pocket maximum.
This program does not cover all, only covers certain weight-loss drugs.

What You Should Know

Medicare has introduced a new, temporary program called the Medicare GLP-1 Bridge Program beginning July 1, 2026, that may help eligible individuals access certain weight-loss medications.

The Medicare GLP-1 Bridge Program is for Medicare recipients who are NOT eligible to receive a GLP-1 through their Part D Medicare Prescription Drug Plan.
The Medicare GLP-1 Bridge Program is for Medicare recipients who do NOT have Diabetes, Moderate to Severe Sleep Apnea or Fatty Liver Disease.

GLP-1 Bridge Program Covered Medications

Foundayo Tablets
Wegovy Oral and Injectable
Zepbound Kwik-Pen

Who May Be Eligible?

A Medicare recipient may qualify if:

Their doctor prescribes a GLP-1 medication for weight loss.
They meet certain health and weight criteria.
Their doctor submits a prior authorization request to the program.

Eligibility is determined by the Medicare program, not VillageCareMAX.

What Will It Cost?

If approved, Medicare recipients will pay a $50 copayment per month for the medication through the program. Even if the Medicare recipient receives Medicare Extra Help, low-income cost-sharing subsidies do not apply.
The $50 does not apply to the Medicare recipient’s deductible, annual out of pocket maximum and is not eligible for the Medicare Prescription Payment Program (M3P).
This cost is set by the Medicare program and is separate from the VillageCareMAX plan costs.

How to Get Started

The Medicare recipient should talk to their doctor about whether a GLP-1 medication is right for them.
A doctor must submit a prior authorization request to the Medicare Bridge program. Medicare will review and determine approval.
The doctor can submit a prior authorization electronically or by fax. The Pharmacist can contact the doctor once a prescription is received either electronically or by fax to request the provider completes the prior authorization. Once the prior authorization is established it will remain in place. If the prescriber switches to a different GLP-1, then a new prior authorization will need to be completed by the prescriber.

Questions & Support

To determine if the GLP-1 Bridge Program is right for the Medicare recipient, they must speak with their doctor.
Eligible beneficiaries may reach out to 1-800-MEDICARE or https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge for more information about the Medicare GLP-1 Bridge.

Helpful Reminders

Drugs used only for weight loss are generally not covered under Medicare prescription drug plans, which is why Medicare created this separate program.
The GLP-1 medication is covered for a 28–30-day supply and is not eligible for a 90-day maintenance medication fill.

Disclaimer

The GLP-1 Bridge Program is a Medicare demonstration program running from July 1, 2026, through December 31, 2027. It operates outside of Medicare Advantage and Part D benefits. VillageCareMAX does not determine eligibility, coverage, or payment for medications provided through this program.