By Franklin Delgado
Starting in July 2026, the Medicare program will launch a pilot program that will allow certain beneficiaries to purchase GLP-1 medications for a co-payment of $50 per month. This program, called Medicare GLP-1 Bridge, will be available until December 2027.
To access, beneficiaries must be enrolled in a Medicare Part D prescription drug plan or in a thought Medicare Earnings with drug coverage. Additionally, they must meet specific clinical criteria related to weight loss.
This program will cover GLP-1 medications in pill and injectable form.
Cost comparison
Although the $50 copay is higher than that of private insurers, which is generally $25 or less, no deductible will be required. Currently, the cost of these medications varies, starting at approximately $149 without insurance.
Medicare Director Chris Klomp noted that these medications can significantly improve the quality of life for patients with obesity.
The implementation of the program seeks to simplify and standardize access, increasing the efficiency of the health system.
Of note, Medicare did not cover medications to treat obesity or weight loss.
Medicare Part D
Medicare Part D is an optional form of prescription drug coverage. Helps pay for brand-name and generic drugs that are not covered by Parts A or B, such as treatments for chronic diseases (diabetes, hypertension), antibiotics, or specific vaccines.
Predominant coverage. It is offered through Medicare-approved private insurers and complements Medicare Customary (Parts A and B) or Medicare Earnings (Part C) plans. Each plan has a formulary (list of covered medications) that is updated annually and includes mandatory categories such as anticancer drugs, antidepressants, and immunosuppressants.
Cost structure. It includes phases such as deductible (up to $590 in 2025 for standard plans), initial copays and, eventually, catastrophic coverage. There are late registration penalties if you don’t join during the open period (October 15 to December 7).
Eligibility. It is available to people with Medicare Part A or B, even without the need for medication, to avoid future penalties. Programs like Extra Help reduce costs for low incomes.
Medicare Earnings
Medicare Earnings, also known as Medicare Part C, is an alternative offered by Medicare-approved private companies that combines Medicare Customary Parts A (hospital) and B (medical) coverage into one plan.
Predominant coverage
- Includes all Medicare Customary benefits, such as hospital stays, doctor visits, outpatient care, and preventive services.
- Many plans add prescription drug coverage (Part D) and extra benefits not included in traditional Medicare.
Additional benefits
- Routine dental, vision and hearing services.
- Fitness programs, over-the-counter items and telehealth.
They offer predictable copays and an annual limit on out-of-pocket expenses for greater budget predictability.
Differences with Medicare fashioned
- They are private plans like HMOs or PPOs, with specific provider networks, unlike Medicare Customary, which allows greater flexibility.
- More than 40% of beneficiaries choose Medicare Earnings for its comprehensive coverage.
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