What Part D plans can and can't cover
The Social Security Act lets Part D exclude the drug classes Medicaid may exclude, and one of them is "agents when used for anorexia, weight loss, or weight gain." So a Part D plan, or a Medicare Advantage plan's drug coverage, can't pay for a GLP-1 drug when weight loss is the only reason you take it.
Plans can cover the same drugs for other medically accepted uses if they're on the formulary, usually with prior authorization:
- Wegovy for lowering heart attack and stroke risk in adults with heart disease and obesity or overweight, or for a form of fatty liver disease (MASH).
- Zepbound for moderate to severe obstructive sleep apnea in adults with obesity.
- Ozempic and Mounjaro for type 2 diabetes.
The Medicare GLP-1 Bridge
CMS's Bridge is a short-term demonstration, available nationwide, that covers Wegovy (injection or tablet), Zepbound (KwikPen only) and Foundayo (tablet) for weight management, at a flat monthly copay set by CMS. Medicare.gov lists the amount.
- Who qualifies: people 18 or older with Medicare drug coverage (a Part D plan, a Medicare Advantage plan with drug coverage, a special needs plan or an employer group plan) and a BMI of 35 or more; or 30 or more with diastolic heart failure, uncontrolled high blood pressure or stage 3a or later kidney disease; or 27 or more with prediabetes, a past heart attack or stroke, or symptomatic peripheral artery disease.
- How: your prescriber sends the prescription, completes a prior authorization when asked and certifies you're in a diet and exercise program. Medicare mails you a letter when you're approved.
- Not eligible: people who already get a GLP-1 through their plan.
What it means in Florida
- You need Medicare drug coverage. The Bridge works with any of Florida's 11 standalone Part D plans or a Medicare Advantage plan with drug coverage. If you have none, Open Enrollment for 2027 coverage ends December 7, 2026.
- Military retirees: TRICARE stopped covering weight-loss drugs for TRICARE For Life beneficiaries on August 31, 2025, when obesity is the primary diagnosis, and points to the Bridge for people with Part D. See military, veterans and TRICARE in Florida.
- Snowbirds: the Bridge covers all states and U.S. territories, including Puerto Rico.
- Hurricane season: these injectables have storage-temperature limits, so plan for power outages. See early refills before a hurricane.
Check eligibility at Medicare.gov/glp1bridge or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). To compare drug coverage, you can request a call from a licensed insurance agent.
Related questions
Which drugs have Medicare negotiated prices in 2027?
Semaglutide's price starts in 2027.
Is insulin capped for people with Medicare in Florida?
The monthly insulin limit.
Does Medicare pay for prescriptions bought abroad?
Mexico, Canada and Latin America.
Sources
- Medicare.gov — Weight loss drugs (Medicare GLP-1 Bridge)
- CMS — Medicare GLP-1 Bridge (July 1, 2026, to December 31, 2027)
- Social Security Act §1927(d)(2), drugs that may be excluded (applied to Part D by §1860D-2(e))
- TRICARE — TRICARE For Life (weight-loss drug coverage update)
- CMS — Medicare Advantage and Part D Landscape files, 2027 (PDP Region 11: Florida)
More questions in this guide
- Does Medicare pay for prescriptions I buy in Mexico, Canada or Latin America?
- Is insulin capped for people with Medicare in Florida?
- Which drugs have Medicare negotiated prices in 2027?
Part of the guide: Medicare drug coverage in Florida: 25 drugs, plain English · All questions
Frequently asked questions
Does the GLP-1 Bridge copay count toward the 2027 Part D cap?
No. CMS says the Bridge runs outside the Part D benefit, so the Part D deductible doesn't apply, no part of the Bridge copay counts toward your out-of-pocket cap, and Extra Help doesn't lower it.
Can I use the Bridge if I have type 2 diabetes?
No. Medicare.gov says people with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease aren't eligible, because their Part D plan may cover a GLP-1 for those conditions instead.
What happens after December 31, 2027?
CMS hasn't announced coverage after the Bridge ends. It says the Bridge was extended through 2027 to collect data ahead of a possible weight-management model in Part D.
Medicare in your Florida county
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