The Medicare GLP-1 Bridge: $50 weight loss medication?
Now open as of July 1, 2026, this Medicare demonstration program may let eligible beneficiaries get covered GLP-1 medications for a flat $50 monthly copay. The criteria are strict. Use the quick checker below to see if you might qualify, and we'll handle the paperwork if you do.
Check your eligibilityDo you qualify for the $50 copay?
Three quick questions. Nothing is saved, and this is an estimate. Final eligibility is determined by Medicare, not by TOM.
What the Medicare GLP-1 Bridge is
For years, Medicare Part D was prohibited from covering medications prescribed solely for weight loss. That left many beneficiaries without affordable access to GLP-1 therapies. The Medicare GLP-1 Bridge is a temporary demonstration program announced by the Centers for Medicare & Medicaid Services (CMS). It gives eligible beneficiaries access to covered weight loss medications for a flat $50 monthly copay.
It runs from July 1, 2026 through December 31, 2027. It is a stepping stone while CMS prepares a longer-term solution (the BALANCE Model). It operates outside your regular Part D benefit, so it is available nationwide to anyone who meets the clinical criteria. Your specific insurer doesn't have to "opt in."
Three ways to meet the criteria
You must have Medicare drug coverage, plus meet one of these BMI-based tiers.
BMI 35+
A starting BMI of 35 or higher meets the criteria on its own, no other condition required.
BMI 30+
Plus a documented diagnosis of heart failure, uncontrolled hypertension, or chronic kidney disease.
BMI 27+
Plus pre-diabetes, a previous heart attack or stroke, or peripheral artery disease.
We handle the paperwork
You don't have to figure out the paperwork. Dr. Le reviews your medical history, confirms you meet the criteria, and handles the approval process for you.
Once it's approved, you simply pick up your covered medication at your pharmacy for the flat $50 copay. The program is open now, so establish care and Dr. Le can start your approval right away.
How the $50 copay works
- Flat $50 for a 30-day supply
- No deductible: it applies immediately
- Doesn't count toward your Part D out-of-pocket maximum (TrOOP)
- Manufacturer coupons and Low-Income Subsidy (LIS) don't apply
Covered medications & what's not
The Bridge covers specific FDA-approved brand-name GLP-1 medications used for weight management: currently Wegovy (injection and tablets), Zepbound (KwikPen), and Foundayo. The exact covered list is set by CMS and may change.
Compounded medications are not part of this government program. If you don't qualify for the Bridge (or a prior authorization is denied), you can still establish care with us as a self-pay patient. Our cash-pay options include compounded semaglutide or tirzepatide when medically appropriate. See our memberships →
A Medicare GLP-1 Bridge doctor who handles the approval for you
The Bridge isn't something you apply to on your own. It takes a licensed physician to document your qualifying condition and submit the prior authorization to Medicare correctly. Dr. Tran Le is a board-certified obesity-medicine physician who personally reviews each patient's history, confirms which clinical tier you meet, and manages the Medicare GLP-1 Bridge approval from start to finish.
Because our practice is 100% online, you don't have to track down a Medicare GLP-1 doctor near you or sit in a waiting room. Dr. Le serves Medicare members statewide across Texas and Utah. She is the same board-certified physician from your first visit through long-term maintenance.
How the costs work: Medicare, through the Bridge, covers your medication. That's the $50 pharmacy copay. Dr. Le is an independent physician and does not bill Medicare for her services. TOM's physician care (your evaluation, prescription, and the prior authorization) is a separate cash-pay membership. See membership pricing →
A Medicare GLP-1 Bridge doctor across Texas & Utah
Fully online. We serve Medicare members in every metro, including:
- Houston, Dallas-Fort Worth, Austin & San Antonio, TX
- Salt Lake City, Provo & St. George, UT
- Every community statewide in between, by telehealth
Medicare GLP-1 Bridge questions
Do I need a doctor to qualify for the Medicare GLP-1 Bridge?
Yes. The Bridge requires a licensed physician to confirm you meet the clinical criteria and to submit the prior authorization to Medicare. You don't enroll on your own. Our Medicare GLP-1 Bridge doctor, Dr. Tran Le, handles that entire process for you.
Is there a Medicare GLP-1 Bridge doctor in Houston, Dallas, or Austin?
Yes, and you won't need to travel to one. Because TOM is a fully online practice, Dr. Le serves Medicare members in Houston, Dallas-Fort Worth, Austin, San Antonio, and everywhere else across Texas and Utah. You get the same board-certified physician wherever you live in the state.
Does Medicare cover Wegovy or Zepbound for weight loss?
Historically it didn't: Medicare Part D was barred from covering medication prescribed solely for weight loss. The Medicare GLP-1 Bridge changes that for eligible members, covering specific FDA-approved brand-name GLP-1 medications for weight management at a flat $50 monthly copay. The exact covered list is set by CMS and can change. See which brands are covered: Wegovy, Zepbound, Ozempic & Mounjaro →
How much will my medication cost through the Bridge?
A flat $50 for a 30-day supply, with no deductible. That's the pharmacy copay for the medication. TOM's physician care is a separate membership (see the question below).
Does Dr. Le accept Medicare?
No. Dr. Le is an independent, cash-pay physician and doesn't bill Medicare for her services. What Medicare covers through the Bridge is your medication, at the $50 pharmacy copay. TOM's physician care (the evaluation, prescription, and prior authorization) is a separate membership.
How soon can I get started?
You can establish care today. Dr. Le will review your history, confirm your tier, and handle your Bridge approval, so you're covered as quickly as the program allows.
Get a head start
Establish care now so Dr. Le can review your history and submit your prior authorization right away. The program is open.
Start your consultationTOM Weight Loss is an independent medical practice and is not affiliated with, endorsed by, or sponsored by CMS or Medicare. Program details, covered medications, and eligibility criteria are set by CMS and are subject to change; final eligibility and approval are determined by Medicare, not by TOM. Medicare covers the medication (the $50 pharmacy copay), not physician services. Dr. Le does not bill Medicare, and TOM's care is a separate cash-pay membership. This page is general information, not medical or insurance advice.