Millions of Medicare enrollees will gain their first-ever coverage for drugs for weight loss under a temporary pilot program that launches July 1. The program, called Medicare GLP-1 Bridge, will cover certain weight-loss medications, including Wegovy and Zepbound, for eligible enrollees.
Eligibility Criteria
To be eligible for the program, Medicare enrollees must meet specific health criteria, including a body mass index (BMI) of 35 or more, or a BMI between 30 and 35 with certain health conditions, such as uncontrolled high blood pressure or prediabetes.
Enrollees who qualify must ask their doctors to send a prescription to the pharmacy and then complete a prior authorization form. The medications can be obtained through pharmacies, and eligible enrollees will pay $50 for a month’s supply.
Impact on Seniors
The program is expected to have a significant impact on seniors who have been struggling with weight-related health issues. Many Medicare enrollees have been unable to afford weight-loss medications, which can cost hundreds of dollars per month.
For example, Mary Abrahamson, a 71-year-old rural Washington resident, has been using a compounded version of the GLP-1 drug tirzepatide for two years, which has helped her shed pounds and have more energy. She and her husband, Jeff, may soon be able to get Zepbound for $50 a month each through the Medicare pilot program.
Original reporting: KTVZ (Central Oregon) — read the source article.
