Medicare
Medicare Part D
If you are on Medicare, you have probably been told Medicare does not cover weight-loss drugs. That was true for years and the law still says it. It is no longer the whole answer.
Two things are true at once right now. The statute still excludes drugs used for weight loss from Part D. And a separate CMS demonstration is paying for some of them at a $50 monthly copay through the end of 2027. Which one applies to you depends on why the drug is prescribed.
What the rules actually say
Federal law excludes drugs used for weight loss from Medicare Part D coverage. The statute's words are "agents when used for anorexia, weight loss, or weight gain" — the exclusion follows the use, not the drug.
42 U.S.C. §1396r-8(d)(2)(A), incorporated by §1395w-102(e)(2) · source
Because the exclusion follows the use, the same drug can be covered for a different approved indication. CMS states that type 2 diabetes, moderate to severe obstructive sleep apnea, and noncirrhotic MASH indications are eligible for Part D coverage.
Centers for Medicare & Medicaid Services, effective August 2026 · source
Since March 2024 Wegovy has an FDA approval to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight — an indication that is not weight loss.
US Food and Drug Administration, effective March 2024 · source
Since December 2024 Zepbound has an FDA approval for moderate to severe obstructive sleep apnea in adults with obesity.
US Food and Drug Administration, effective December 2024 · source
CMS is running a short-term demonstration, the Medicare GLP-1 Bridge, giving eligible Part D beneficiaries access to certain GLP-1 drugs between July 1, 2026 and December 31, 2027, at a $50 monthly copay.
Centers for Medicare & Medicaid Services, effective August 2026 · source
The Bridge runs outside the normal Part D benefit. The $50 does not count toward your true out-of-pocket total, and low-income subsidies do not apply to it.
Centers for Medicare & Medicaid Services, effective August 2026 · source
Bridge eligibility is attested by your prescriber and needs a BMI of 35 or more; or 30 or more with heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease stage 3a or worse; or 27 or more with pre-diabetes, a prior heart attack, a prior stroke, or symptomatic peripheral artery disease.
Centers for Medicare & Medicaid Services, effective August 2026 · source
You are not eligible for the Bridge if you have type 2 diabetes, obstructive sleep apnea or MASH — those route to ordinary Part D coverage instead — or if you already filled a GLP-1 through Part D in 2026.
Centers for Medicare & Medicaid Services, effective August 2026 · source
A 2025 proposed rule that would have added anti-obesity medication coverage to Part D was not finalized. CMS said so explicitly in April 2025, so any page describing that rule as law is wrong.
Centers for Medicare & Medicaid Services, effective April 2025 · source
What to do
Find out which door you are at
If you have type 2 diabetes, sleep apnea or MASH, you are asking Part D to cover an approved indication. If you have none of those, you are asking about the Bridge. They are different requests with different rules.
Ask your prescriber to attest to the Bridge criteria
The Bridge runs on a prescriber attestation of your BMI and qualifying condition. Nothing you do yourself starts it.
For a Part D denial, follow the appeal notice
For a Part D coverage denial, file a redetermination within 65 calendar days of the coverage determination notice; a further reconsideration request is due within 65 calendar days of the redetermination notice. These Part D appeal rules do not establish an appeal right under the separate GLP-1 Bridge.
What it costs you
- Service grievance or coverage appeal?
- Wegovy coverage for MASH
- Does Medicare cover Wegovy for heart disease?
- What Foundayo costs, and how the $50 Bridge applies to it
- Why the Zepbound savings card is closed to Medicare, and what is not
- TRICARE For Life and weight-loss GLP-1s
- Zepbound for sleep apnea: covered by Part D, not the Bridge
- What the Wegovy pill costs, and the $50 Bridge price
- Why the weight-loss exclusion follows the use, not the drug
If the appeal fails, or you cannot wait
Cash-pay telehealth is the fallback, not the bargain: you pay the whole cost yourself, and a covered prescription is almost always cheaper than any of these. Use this route when coverage has actually been exhausted, or when you need to start while an appeal runs.
These companies pay us a commission if you start care through the links below. That is how this site is funded, and it does not change what is written above. How we pay for this.
| Company | What we found on its own site |
|---|---|
| PartnerShedRxCheck availability | Injections plus needle-free drops and lozenges. You see a price only after the questionnaire, and the oral forms aren't sold in sixteen states. |
| PartnerHealthRXCheck availability | Compounded semaglutide at $133 a month on a three-month plan ($99 on twelve), tirzepatide from $209 ($179 on twelve). Its member reviews are labeled illustrative composites, not real patients. |
| PartnerMEDGmCheck availability | GLP-1 injections from $179 and tablets from $249. Brand options are a membership plus the drug's own cost: $99 for Zepbound or Wegovy, $171 for Ozempic. It discloses AI content and actor imagery. |
| PartnerBodybuilding Health+Check availability | Compounded tirzepatide at $174.67 to $209 a month, lower the more months you buy at once; semaglutide is tiered the same way. Operated by Dynamo Group LLC. |
| PartnerStrut HealthCheck availability | A telehealth storefront where weight loss is one of six categories. No GLP-1 price is published on the page our link opens. |
| PartnerRxSpan MDCheck availability | Multi-category telehealth that promises transparent pricing, then publishes no GLP-1 price on the page our link opens. |
| PartnerSnagRxCheck availability | Compounded semaglutide at $69 a month and tirzepatide at $119, the same at every dose, with no membership. Both are countdown sale prices, marked down from $299 and $399. Not available in Louisiana. |
| PartnerSkinnyRxCheck availability | Compounded semaglutide and tirzepatide injections at $99 for the first month, tablets at $149 and $199. No second-month price is printed for any of them. |
| PartneryourEraCheck availability | Compounded semaglutide at $79.20 a month and tirzepatide at $159.20. Both are six-month-plan prices, and the plan carries a six-month commitment. |
| PartnerbmiMDCheck availability | Compounded semaglutide from $119 a month and tirzepatide from $179. Both are limited-time sale prices, marked down from $228.60 and $349.20. |
| PartnerCollectiveCheck availability | Compounded semaglutide at $59 a month and tirzepatide at $69 at every dose, plus a required $199 yearly membership. It's free for 21 days, then billed for the full year at once, and it isn't refundable. |
| PartnerSprout HealthCheck availability | Compounded semaglutide from $149 a month and tirzepatide from $199, on plans that renew automatically. Also lists brand Wegovy and Zepbound. |
| PartnerWillowCheck availability | Compounded semaglutide at $299 a month (weekly injection or daily tablet) and tirzepatide injections at $399. HSA and FSA accepted; a full refund applies only if you cancel before the prescription reaches the pharmacy. |
| PartnerHumeCare+Check availability | A self-pay membership with no price shown before checkout, renewing automatically. The home page promises your money back if you don't lose 10 percent in six months; the terms limit that to 90 days, first-time users and no measurable loss. |
| PartnerEnhance MDCheck availability | Offers compounded semaglutide and tirzepatide with provider consultations and follow-up. Compounded drugs are not FDA-approved; ask which pharmacy will dispense your prescription and what continuing care includes. |
| PartnerCoreAge RxCheck availability | Compounded semaglutide advertised at $99 a month at every dose. The page our link opens has shown $149 instead, and a consultation fee can be added that may not be refundable. |
| PartnerOakCheck availability | One flat price at every dose, with shipping and supplies included free. |
| PartnerGala HealthCheck availability | One price at every dose. The advertised rate needs a yearly subscription. |
| PartnerDirect MedsCheck availability | One price at every dose from $147, with no monthly membership. The page states its discount two ways ($150 off in the banner, up to $200 off on the tiles), so check the total at checkout. |
| PartnerFoundCheck availability | Bills clinician visits to your insurance where it's in network, with the drug charged separately. Its Medicare offer, brand GLP-1s from $50 a month, doesn't count toward your Part D deductible or out-of-pocket maximum, and Extra Help doesn't apply. |
| PartnerEdenCheck availability | Semaglutide at $99 a month at every dose, with no membership on the page our link opens. Eden's own site pairs the same $99 with a required membership ($39 the first month, then $99), so check which one you're signing up for. |
Prices in those notes were read from each company's own site in September 2026, October 2026 and August 2026, and they change often. Check the current number before you buy.
Where this comes from
- 42 U.S.C. §1396r-8(d)(2)(A), incorporated by §1395w-102(e)(2) — www.law.cornell.edu/uscode/text/42/1396r-8
- Centers for Medicare & Medicaid Services, effective August 2026 — www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-
- US Food and Drug Administration, effective March 2024 — www.fda.gov/news-events/press-announcements/fda-approves-first-treatment
- US Food and Drug Administration, effective December 2024 — www.fda.gov/news-events/press-announcements/fda-approves-first-medicatio
- Centers for Medicare & Medicaid Services, effective August 2026 — www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-
- Centers for Medicare & Medicaid Services, effective April 2025 — www.cms.gov/newsroom/fact-sheets/contract-year-2026-policy-and-technical
Your state's Medicaid posture is in the coverage matrix, and the appeal routes are on the procedures page. What individual insurers publish about these drugs — and the much smaller thing those documents settle about your own plan — is on the carrier pages.