Millions of Medicare enrollees will gain their first-ever coverage for weight-loss drugs under a temporary pilot program that launches July 1. The program, called Medicare GLP-1 Bridge, will cover certain medications, including Wegovy and Zepbound, for eligible enrollees.

Eligibility Criteria

To be eligible, Medicare enrollees must have 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. They must also be enrolled in a Part D drug coverage plan and meet specific health criteria.

Many Medicare enrollees are uncertain whether they are eligible for the program. Some, like Deb Cooperman, 65, are hoping to qualify for the reduced price of $50 a month for Zepbound, which has allowed her to shed 30% of her body weight and given her more energy and less pain.

Medications Covered

The pilot program covers Wegovy tablets and injections, Zepbound KwikPens and Foundayo tablets. It does not cover single-dose Zepbound vials or pens. Both Novo Nordisk, which makes Wegovy, and Eli Lilly, which makes Zepbound and Foundayo, say they have enough supply to meet the new demand.

Doctors and patient advocates have been clamoring for years to expand Medicare coverage to weight-loss drugs, arguing that obesity should be treated like any disease. The cost of buying GLP-1 medications without insurance can still run into hundreds of dollars.

Original reporting: KEYT (Ventura/Santa Barbara) — read the source article.