Does Medicare cover Zepbound and Wegovy? The GLP-1 Bridge sets $50 a month through 2027
From July 1, 2026 through December 31, 2027, eligible people with Medicare Part D can get Wegovy (pen and pill), Foundayo and the Zepbound KwikPen for weight reduction at a flat $50 a month copay under the Medicare GLP-1 Bridge, a CMS demonstration that runs outside regular Part D coverage.
What is the Medicare GLP-1 Bridge?
Medicare has been barred by law from covering drugs used specifically for weight loss; Part D plans can cover GLP-1s only for other FDA-approved uses such as type 2 diabetes, cardiovascular risk reduction or sleep apnea[1]. The Bridge is a short-term, nationwide CMS demonstration that adds coverage of select GLP-1s for obesity for Part D enrollees from July 1, 2026 to December 31, 2027. It was originally set to end December 31, 2026 and was extended when CMS delayed the BALANCE Model in Part D[1].
Because it is separate from Part D, plans don’t opt in and don’t bear the cost; pharmacies submit claims to a central processor[1].
Which drugs are covered and what do they cost?
KFF lists "all formulations of both Foundayo and Wegovy and the KwikPen formulation of Zepbound" at a copayment of $50 per month[1]. Lilly’s Foundayo savings page lists $50 per month for eligible Part D patients under the Bridge[2], and Novo’s Wegovy offer page lists a $50 Medicare price[3].
| Drug | Covered under Bridge? | Monthly copay |
|---|---|---|
| Wegovy pen (incl. HD) | Yes | $50 |
| Wegovy pill | Yes | $50 |
| Foundayo | Yes | $50 |
| Zepbound KwikPen | Yes | $50 |
| Zepbound single-dose vials | Not listed | — |
| Ozempic, Mounjaro | No (diabetes drugs; covered by Part D for diabetes) | — |
Manufacturers agreed to a net price of $245 per month supply under the Bridge; that is what CMS ends up paying, not what you pay[1].
Who qualifies?
You must be enrolled in a Part D plan, and your prescriber must submit a prior authorization request attesting the drug is prescribed to reduce excess body weight and maintain weight reduction, and that you meet one of three sets of BMI and clinical criteria CMS published[1]. Beneficiaries must be 18 or older[1]. We don’t restate the clinical thresholds here; your prescriber submits the attestation.
Does the $50 count toward my Part D out-of-pocket cap?
No. Because the Bridge operates outside Part D, the $50 does not count toward your Part D deductible or the $2,100 out-of-pocket maximum in 2026 ($2,400 in 2027), and it stays $50 regardless of benefit phase[1]. Low-Income Subsidy (Extra Help) cost-sharing does not apply to the Bridge[1].
What if I already get a GLP-1 through Part D?
If your Part D plan already covers a GLP-1 for a Medicare-covered use such as type 2 diabetes, cardiovascular risk reduction or sleep apnea, you keep getting it through Part D, not the Bridge. The Bridge only covers GLP-1s used for obesity[1].
What happens after 2027?
KFF says it is uncertain how people will keep Medicare coverage of obesity GLP-1s after the Bridge ends at the end of 2027, pending CMS action on the BALANCE Model in Part D in 2028[1]. Without coverage, the self-pay prices on our price pages are the fallback; manufacturer savings cards exclude government beneficiaries[4][2].
Monthly cost arithmetic
At $50 a month, 12 months of a Bridge-covered drug is $600 in copays. Without the Bridge, the same year of Wegovy at the $349 self-pay price is $4,188[3], and Zepbound KwikPen at $449 for 13 four-week fills is $5,837[5]. These are arithmetic examples, not advice on whether a drug is right for you.
Questions people ask
When does the Medicare GLP-1 Bridge start and end?
It runs from July 1, 2026 to December 31, 2027. It was originally scheduled to end December 31, 2026.
Is Zepbound covered by the Medicare GLP-1 Bridge?
The Zepbound KwikPen is covered. KFF does not list Zepbound single-dose vials.
Does Extra Help lower the $50 copay?
No. KFF says Low-Income Subsidy cost-sharing does not apply under the Bridge.
Do I need prior authorization?
Yes. Your prescriber must submit a prior authorization request attesting to the weight-reduction use and that you meet CMS clinical criteria.
Sources
Every price above links to one of these pages. We loaded each one and saved a copy on the date shown.
- What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge . KFF, published May 11, 2026. Checked .https://www.kff.org/medicare/what-to-know-about-the-balance-model-for-glp-1s-in-medicare-and-medicaid/
- Foundayo coverage and savings (self-pay terms) . Eli Lilly and Company. Checked .https://foundayo.lilly.com/coverage-savings
- Wegovy savings offer and self-pay prices (pen, HD pen and pill) . Novo Nordisk (NovoCare). Checked .https://www.novocare.com/obesity/products/wegovy/savings-offer.html
- Mounjaro savings and coverage . Eli Lilly and Company. Checked .https://mounjaro.lilly.com/savings-resources
- Zepbound on LillyDirect (vial and KwikPen self-pay prices) . Eli Lilly and Company. Checked .https://www.lilly.com/lillydirect/zepbound