Medicare's $50 GLP-1 Bridge, in plain English.

Who qualifies

• You have Medicare drug coverage: a Part D plan, or a Medicare Advantage plan with drug coverage.
• Your BMI when you started treatment was 35 or higher; or 30 or higher with heart failure (preserved ejection fraction), uncontrolled high blood pressure or stage 3 or worse kidney disease; or 27 or higher with prediabetes, a past heart attack or stroke, or peripheral artery disease with symptoms.
• You're taking it for weight management, alongside eating and activity support.
• Your drug plan doesn't already cover your GLP-1.

Have type 2 diabetes, moderate to severe sleep apnea, or MASH (fatty liver disease)? Your Part D plan may cover a GLP-1 for that reason directly, so ask your plan first.

How to use it

1. Make sure you have Part D or a Medicare Advantage drug plan. Medicare open enrollment runs October 15 to December 7.
2. Your doctor prescribes a covered medicine, sends prior authorization if it's needed, and confirms it's part of a diet and exercise plan.
3. You get a coverage letter in the mail.
4. You fill it at your pharmacy, which runs it through the Bridge for the $50 copay.
5. Not sure? Call 1-800-MEDICARE (1-800-633-4227), or use the eligibility checker on Medicare.gov.