Key Points
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Medicare doesn’t currently cover GLP-1s for weight loss.
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A new program was supposed to change this, but it’s been indefinitely postponed.
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The GLP-1 Bridge program, beginning in July 2026, has been extended through 2027.
GLP-1s are some of the most popular prescription medications today. Unfortunately, when it comes to them, many Americans still have to choose between their health and their pocketbooks. This includes Medicare beneficiaries, who currently only have their GLP-1s covered if they use the medications to treat an underlying condition, like type 2 diabetes.
All that seemed about to change a few months ago, when the government promised a new program — the Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) model — that would cover GLP-1s for weight loss for Medicare beneficiaries. However, it’s been tabled indefinitely.
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The BALANCE model was originally scheduled to take effect in January 2027 and would have allowed Medicare Part D sponsors to decide whether to cover GLP-1s for weight loss. However, that plan has been delayed, with no indication of when it will now take effect.
That doesn’t mean Medicare beneficiaries are out of luck, though. There’s a new Medicare GLP-1 Bridge program that will take effect in July 2026. This will enable Medicare beneficiaries to have their GLP-1s for weight loss covered by Medicare, as long as their healthcare provider submits a prior authorization request and a prescription for a covered medication.
This program was initially only supposed to last through the end of the year, but the government has now extended it through 2027. It’s unclear what will happen to it beyond this point.
It’s also worth noting that, as the GLP-1 Bridge program operates outside of Medicare Part D plans, any money spent on these medications for weight loss won’t count toward your Medicare Part D deductible or out-of-pocket maximum. This could increase your retirement healthcare costs this year. If you have any questions about this coverage, contact the Centers for Medicare & Medicaid Services for more information.
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