Medicare will start covering weight-loss drugs on July 1 for the first time
The temporary demonstration sidesteps a federal ban on obesity-only coverage and could save beneficiaries thousands of dollars a year.
- On July 1, the Centers for Medicare & Medicaid Services will launch the Medicare GLP-1 Bridge program, marking the first time Medicare will help pay for drugs prescribed solely for obesity.
- Federal law prohibits Medicare from covering weight-loss drugs, prompting the administration to conduct this temporary demonstration project following an agreement with Eli Lilly and Novo Nordisk to reduce costs.
- Eligible enrollees pay $50 monthly, though this copayment does not count toward annual out-of-pocket maximums; patients must have a BMI of 35 or higher, or lower BMI with specific health conditions, to qualify.
- Medicare beneficiaries who already receive GLP-1 drugs for diabetes or sleep apnea will continue using their regular Part D prescription drug coverage, as the pilot excludes those already covered.
- Running through the end of 2027, the Bridge program offers no clear path forward for coverage once it lapses; unless Congress changes the law or CMS issues an extension, patients may face higher cash prices.
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Medicare Launches New Weight Loss Drug Pipeline.
Medicare’s new weight-loss drug program offers affordable access to GLP-1 medication for seniors, marking a significant shift in healthcare coverage and efforts to combat obesity.PULSE POINTS WHAT HAPPENED: Medicare’s first-of-its-kind weight-loss drug program has officially launched, giving American seniors access to GLP-1 drugs at a subsidized cost. DETAIL: On Wednesday, Medicare & Medicaid Services launched a new program allowing Americans ag…
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