“Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge” by Juliette Cubanski and Nolan Sroczynski, KFF
Quote:
“On July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will roll out a new, temporary program covering GLP-1s for obesity for people with Medicare. The program, known as the Medicare GLP-1 Bridge, provides coverage of GLP-1s used for weight reduction and weight management to eligible beneficiaries enrolled in Medicare Part D, although the program will operate outside of the Part D benefit and payment system. Under the Medicare GLP-1 Bridge, eligible beneficiaries can get Medicare coverage of GLP-1s for obesity for a $50 monthly copayment, which will not count towards the Part D deductible or out-of-pocket spending cap and Part D Low-Income Subsidy cost-sharing assistance will not apply. The temporary program, running from July 2026 through December 2027, does not change the current statutory prohibition on Medicare coverage of drugs used for weight loss but instead is being established using the federal government’s Section 402 demonstration authority.”
LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform:
This is interesting. Given the connection between obesity and both physical and cognitive long-term disability, funding drugs to reduce obesity may cut Medicaid LTC expenditures substantially. Or, more realistically, reduce the rate of spending increases.