Episode #5
Medicare’s $50 GLP-1 Program: Who Qualifies and How to Apply
Medicare has launched a new way for some beneficiaries to access GLP-1 medications for weight management—but not everyone will qualify. In this episode, Amanda explains the Medicare GLP-1 Bridge, including who may qualify, how the prior authorization process works, and why some people must still request coverage through their regular Medicare Part D plan. You’ll learn: • What the Medicare GLP-1 Bridge is • Which Medicare beneficiaries may qualify • Why certain medical diagnoses are handled through Part D instead • The BMI and health criteria used for eligibility • How the prior authorization form works • What your doctor and pharmacy may need to submit • What eligible beneficiaries pay The Medicare GLP-1 Bridge is a temporary CMS demonstration running from July 1, 2026, through December 31, 2027. Eligible beneficiaries pay a $50 copay for covered medications furnished through the program. The Part D deductible does not apply, but the $50 copay does not count toward Part D out-of-pocket costs. Coverage is not automatic. Eligibility depends on Medicare Part D enrollment, the reason the medication is being prescribed, clinical criteria, and completion of the required prior authorization process. Learn more from Medicare: https://www.medicare.gov/glp1bridge Questions or ideas for a future episode? Email: [info@imwithamanda.com](mailto:info@imwithamanda.com) Please like this video, subscribe, and turn on notifications for more straightforward Medicare updates. We are not a government agency. We are licensed insurance agents who discuss insurance programs such as Medicare Advantage, Medicare Supplements, and Medicare Part D prescription drug coverage. Any specific plan information we provide is limited to the plans we offer in your area. Please visit Medicare.gov or call 1-800-MEDICARE for information about all your options. #Medicare #GLP1 #MedicarePartD #WeightLossMedication #MedicareCoverage #GLP1Bridge 00:00 Medicare GLP-1 coverage update 00:10 What changed with GLP-1 access 00:54 Who may qualify for the program? 01:27 The prior authorization form 02:07 Understanding the eligibility requirements 02:34 What patients should do next 02:55 Subscribe and contact Amanda 03:21 Medicare compliance disclosure Support the show
