Medicare will help pay for weight-loss drugs Wegovy, Zepbound. What to know

Millions of older adults could soon qualify for popular GLP-1 weight loss drugs such as Wegovy and Zepbound under a Medicare pilot program.

On July 1, the Centers for Medicare & Medicaid Services will launch the Medicare GLP-1 Bridge program for enrollees who qualify for prescription weight-loss medication based on height, weight and other criteria. Older adults who get the weight-loss drugs will pay a monthly $50 copay with Medicare covering the rest of the cost.

The bridge program is a significant change because Medicare, the federal health program mainly for adults 65 and older, has been prohibited from covering weight-loss medications, including GLP-1s. The bridge program will run through the end of 2027.

The program could help older adults afford the popular medications sought by many despite list prices that can exceed $1,000 and spotty insurance coverage. Although drugmakers have cut prices for cash-paying customers, more than half of adults on GLP-1s say the drugs have been difficult to afford, according to KFF, a health policy nonprofit.

KFF said 9% of adults 65 and older used GLP-1s, while usage was slightly higher for young adults.

Medicare's bridge program comes as companies that provide health insurance for most working-age adults are cutting back coverage. A survey from Mercer, a consultant, published June 11 found about 6% of large employers will drop coverage of GLP-1 weight-loss drugs in 2026 and another 5% plan to drop coverage in 2027. Nearly half of large employers covered the weight loss drugs in 2025.

Employees that pay for insurance benefits "have seen their costs continue to rise," said Raymond Brown, Mercer's North American clinical pharmacy leader.

If employers don't want to drop coverage of the popular and expensive medications, they might add extra requirements for workers such as regularly checking in with a weight-loss coach in order to regularly get GLP-1s.

Employers are asking, "Can I continue to manage these costs?" Brown said.

Who will be eligible for Medicare's GLP-1 coverage?

Medicare beneficiaries must have prescription drug coverage, known as part D, to be eligible for the medications. People must get a prescription from a doctor or other licensed prescriber, and they will be subject to prior authorization.

Not everyone will qualify for the program. You must be eligible for anti-obesity drugs based on your body-mass index, which is a measure of height and weight. Those with a BMI of 35 or higher will generally qualify. Some with a BMI of 27 or higher will qualify if they have other medical conditions such as pre-diabetes and peripheral artery disease.

Medicare recipients who already get a GLP-1 drugs due to Type 2 diabetes, sleep apnea or heart disease risk won't get the medication under the bridge program. They will continue to get the medications through their regular part D prescription drug coverage.

Although Medicare recipients must have a part D plan to qualify for GLP-1s under the bridge program, the private insurers that administer part D plans won't be involved in the bridge program. Medicare will handle approvals, process claims and pay pharmacies, according to Medicare Rights Center.

Medicare hasn't released an estimate of how many Americans might qualify for the anti-obesity drugs under the bridge program.

Based on 2020 data, KFF estimated about 13.7 million Medicare recipients either had obesity or were overweight.

Which drugs will be covered under Medicare?

Novo Nordisk's Wegovy, which is available as a shot and a pill, will be covered under the bridge program. Eli Lilly's KwikPen version of the injectable Zepbpound and the drugmaker's weight-loss pill Foundayo will qualify for the bridge program.

Novo and Lilly have sought to outmaneuver one another with price cuts for cash-paying customers whose insurance plans don't cover the medications.

Novo previously dropped the price for injectable Wegovy and most dosages of the diabetes drug Ozempic to $349 a month, down from $499, for consumers who purchase the medication directly from the drugmaker, telehealth partners or retail pharmacies.

Lilly also previously announced price cuts for consumers who directly purchase Zepbound.