Eligible seniors can get GLP-1s for $50 a month for weight loss alone

Key Points:

• Starting Wednesday, Medicare will cover GLP-1 medications for obesity-related weight loss without requiring other medical conditions, allowing eligible beneficiaries to access these drugs for a $50 monthly copay.
• This coverage is part of a new federal pilot bridge program, approved by Health and Human Services Secretary Robert F. Kennedy Jr., and will run through December 31, 2027, overcoming previous federal restrictions on obesity drug coverage under Medicare Part D.
• The program includes Eli Lilly’s Foundayo and Zepbound and Novo Nordisk’s Wegovy, with specific formulations covered and prior authorization required based on strict BMI and health criteria more restrictive than FDA guidelines.
• Approximately 3.8 million Medicare beneficiaries may be eligible, with the government negotiating a reduced price of $250 per month for these medications, while patients pay a $50 copay that does not count toward their annual deductible.
• Prescriptions can be filled at local pharmacies or through manufacturers’ mail-order services, aiming to improve access and affordability of these medications for seniors and eligible Medicare enrollees.