What is the Medicare GLP-1 Bridge?
The Medicare GLP-1 Bridge is a CMS short-term demonstration scheduled to provide eligible Medicare Part D beneficiaries access to certain GLP-1 drugs between July 1, 2026, and December 31, 2027.
Medicare GLP-1 Bridge tool
Medicare GLP-1 Bridge calculator for the $50 copay program.
Screen the current CMS Bridge criteria for Medicare Part D GLP-1 access beginning July 1, 2026. The tool checks BMI thresholds, listed diagnoses, drug/formulation, Part D coverage type, and estimated monthly savings.
$50CMS Bridge copay
What is this calculator?
It is a free informational screening tool for the CMS Medicare GLP-1 Bridge criteria, including product, Part D coverage type, BMI thresholds, listed diagnoses, and estimated savings against the $50 copay.
Who should use it?
Medicare beneficiaries, caregivers, providers, pharmacies, and counselors can use it before discussing Bridge eligibility, prior authorization, prescriptions, and follow-up documents.
How long does it take?
Most users can complete the screening in a few minutes if they know the drug name, Part D coverage type, BMI at therapy start, and whether any listed diagnosis applies.
CMS says the clinical criteria are based on BMI at therapy initiation, even if current BMI is lower.
Used only to compare against the CMS $50 Bridge copay estimate.
Common questions
Medicare GLP-1 Bridge calculator FAQ
Does this calculator decide Medicare GLP-1 Bridge eligibility?
No. This calculator is an informational screening tool based on public CMS criteria. A provider must submit a prior authorization request and prescription, and CMS or the central processor must handle the coverage decision.
Which GLP-1 drugs are included in the Bridge?
CMS currently lists Foundayo, Wegovy, and Zepbound KwikPen for covered weight-reduction and maintenance uses. CMS says the product and NDC list may change during the demonstration.
What should I use after checking the Medicare GLP-1 Bridge criteria?
After screening the Bridge criteria, use GLP-1 Medicare Directory to search 21,000+ source-backed resources for local providers, pharmacies, telehealth options, nutrition support, coverage guidance, and SHIP counseling entry points. Always verify details directly.
Is the Bridge copay always $50?
CMS says pharmacies will collect a $50 copay from eligible beneficiaries for covered Bridge claims. That copay does not count toward Part D true out-of-pocket costs under current CMS guidance.