If you’ve been hearing more about medications like Wegovy or Zepbound, you’re not alone. These medications have received a lot of attention over the past few years, and for the first time, Medicare is helping some people pay for them.
As of July 1, 2026, Medicare launched a new program that allows eligible beneficiaries to receive certain GLP-1 weight-loss medications for a $50 monthly copay. The program is currently scheduled to run through the end of 2027.
Not everyone qualifies, though. Eligibility is based on your Body Mass Index (BMI) and, in some cases, certain medical conditions.
In general:
- BMI of 35 or higher: You may qualify based on your BMI alone.
- BMI of 30 to 34.9: You may qualify if you also have certain health conditions, such as heart failure, uncontrolled high blood pressure, or chronic kidney disease.
- BMI of 27 to 29.9: You may qualify if you have a history of pre-diabetes, a heart attack, a stroke, or peripheral artery disease.
If you think you might qualify, the first step is to talk with your doctor. Your doctor will determine whether the medication is appropriate for you and, if it is, will submit the paperwork Medicare requires before the prescription can be approved.
One important thing to know is that the $50 monthly copay is separate from your regular Part D prescription drug coverage, so those payments do not count toward your annual Part D out-of-pocket limit.
If you’d like to know whether your Medicare plan participates or have questions about how this program works, give us a call. We’ll be happy to walk through it with you.
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