Which GLP-1 Drugs Does Medicare Cover?

The Medicare GLP-1 Bridge covers three GLP-1 drugs, and for one of them only a specific device is covered. Anything outside this list is not covered by the program.

Covered under Medicare GLP-1 Bridge

On the Medicare prior authorization form, the prescriber selects one of exactly five options: Foundayo Tablets, Wegovy Injection, Wegovy Tablets, Wegovy HD Injection, or Zepbound KwikPen.

Not covered

• Zepbound single-dose vials and Zepbound single-dose pens. Only the KwikPen qualifies. If your prescription is written for a vial or single-dose pen, it will not process under the program.
• Any other GLP-1 product, including ones with the active ingredients dulaglutide or liraglutide.
• Compounded GLP-1 products.

What counts as a "GLP-1" for eligibility purposes

This matters because you are not eligible for the Bridge if you already receive a GLP-1 through your Part D plan. CMS defines GLP-1 drugs as products with any of these active ingredients:

• Semaglutide
• Tirzepatide
• Orforglipron
• Dulaglutide
• Liraglutide

So if your Part D plan is already paying for a GLP-1 for any reason, keep getting it through your plan rather than switching to the Bridge.

Medicare's prior authorization form is explicit that a GLP-1 request must go to the Part D plan, not the Bridge, if the patient has any of these:

• Moderate to severe obstructive sleep apnea (OSA)
• Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver scarring, formerly called NASH
• Type 2 diabetes
• Established cardiovascular disease, where the drug is prescribed to reduce the risk of major adverse cardiovascular events

Switching drugs later

Once you are approved, your prior authorization stays valid through December 31, 2027 for refills and for dose changes. If you switch to a different GLP-1 drug, your provider will need to get a new approval.

More on Medicare and GLP-1 drugs

• What Is the Medicare GLP-1 Bridge Program?
• Who Qualifies for the Medicare GLP-1 Bridge?
• What Do GLP-1 Drugs Cost Under Medicare?
• How Do I Get GLP-1 Coverage Through Medicare?

Questions?

Call or text our Medicare team at (312) 726-6565, or call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Compare Medicare plans and get a quote

Sources

• Medicare.gov - Weight loss drugs
• CMS.gov - Medicare GLP-1 Bridge
• CMS Product No. 12234 - Medicare GLP-1 Bridge fact sheet (PDF)
• CMS - Medicare GLP-1 Bridge Prior Authorization Request Form (PDF)

This article is general information, not medical or coverage advice. Talk with your doctor about whether a GLP-1 drug is right for you, and confirm your own eligibility with Medicare.