Does Medicare cover Wegovy or Zepbound in 2026?

Yes, if you qualify. Since July 1, 2026, the Medicare GLP-1 Bridge has let eligible Part D enrollees get Wegovy, Zepbound KwikPen or Foundayo for weight loss at $50 a month, and it runs through December 31, 2027. You need a prescription and an approved prior authorization.

If you take Zepbound for sleep apnea or Wegovy for heart risk, the Bridge isn’t your route: those uses go through your regular Part D plan. Below is what’s covered, who qualifies and what changes in 2027.

What the Medicare GLP-1 Bridge is

The Medicare GLP-1 Bridge is a temporary CMS program that sets a $50 monthly copay for weight-loss GLP-1s for eligible Part D enrollees. CMS described the $50 access in May 2026, and drug makers supply the medicines at a $245 net monthly price, according to KFF.

Two details shape what the $50 costs you over time:

• The copay doesn’t count toward your Part D out-of-pocket maximum, so a full year of fills adds $600 outside that cap.
• Low-income subsidies don’t apply, so the copay stays $50 even if you get help with other Part D costs.

CMS’s BALANCE model was set to bring Medicare coverage of these drugs in 2027. On April 21, 2026, CMS said the Medicare side won’t launch in 2027 and extended the Bridge through the end of 2027 instead.

Which drugs the Bridge covers

The CMS prior-authorization form lists Foundayo, Wegovy (injection, tablets and the 7.2 mg HD dose) and Zepbound KwikPen as covered.

Scroll sideways to see the full table

Self-pay prices are from NovoCare Pharmacy and LillyDirect (Zepbound, Foundayo), read October 17, 2026. Zepbound’s $449 price at 7.5 mg and up requires a refill within 45 days.

For someone who qualifies, the gap is large. At full dose, the Wegovy injection costs $349 a month self-pay against $50 on the Bridge, a difference of $299 a month or $3,588 over a year. For the Zepbound KwikPen at 7.5 mg or higher with on-time refills, it’s $449 against $50, or $4,788 a year. Lilly also said at Foundayo’s US launch in April 2026 that eligible Part D patients would pay $50 a month from July 1, 2026.

Only the Zepbound KwikPen is on the form, not the vials. Ozempic and Mounjaro are diabetes drugs, and the form sends diabetes use to your regular Part D plan. Compounded semaglutide and tirzepatide aren’t on the list either: they are not Wegovy or Zepbound, and not generics of them. A compounding pharmacy prepares them, and they are not FDA-approved or reviewed by the FDA for safety, effectiveness or quality.

Our pages on Wegovy, Zepbound and Foundayo cover each drug in more depth.

Who qualifies

You need Part D drug coverage and a prescription for weight loss. The prior-authorization form then asks for your BMI band and whether you have any of these conditions:

• prediabetes
• a past heart attack or stroke
• peripheral artery disease
• heart failure with preserved ejection fraction (HFpEF)
• uncontrolled high blood pressure
• chronic kidney disease, stage 3a or higher

CMS sets the BMI bands for each of these conditions, and your prescriber can tell you which band you fall in, and you can check your number first with our BMI calculator.

For context, the FDA’s Zepbound approval covered adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition such as high blood pressure, type 2 diabetes or high cholesterol. That’s the drug’s approval standard, not necessarily the Bridge’s.

If you use these drugs for something other than weight loss

The form sends these uses to your regular Part D plan instead of the Bridge:

• obstructive sleep apnea, which Zepbound has been approved to treat since December 20, 2024
• MASH, a liver disease the Wegovy injection is approved for
• type 2 diabetes
• lowering cardiovascular risk, a Wegovy indication

In those cases your plan’s own coverage rules and copay apply, not the $50 Bridge price.

How to get it

1. Check that you have Part D drug coverage.
2. See a licensed clinician who can judge whether a GLP-1 suits you and whether you meet the Bridge criteria.
3. Your prescriber completes the CMS prior-authorization form with your BMI band and any qualifying conditions.
4. Once approved, you pay $50 a month for the covered drug.

Many online GLP-1 programs are cash-pay only and mainly sell compounded drugs that aren’t on the Bridge list. If you want to use the Bridge, look for a prescriber who works with Medicare. Our insurance rankings are a starting point.

What changes in 2027

The negotiated price comes from the Inflation Reduction Act’s drug price negotiation program and covers semaglutide sold as Ozempic, Rybelsus and Wegovy. It’s a price for the drug, not your copay. Separately, Novo Nordisk plans to cut its list price, the price before rebates, for Wegovy 2.4 mg and the 25 mg tablet to $675 a month on the same day. The CMS pages we checked don’t say what replaces the Bridge after 2027.

If you have Medicaid instead

Medicaid is a separate program, and coverage depends on your state. KFF counted 13 state Medicaid programs covering GLP-1s for obesity as of January 2026, down from 16 in October 2025.

The Medicaid side of BALANCE is active, and states can join between May 2026 and January 1, 2027, depending on state and manufacturer participation (CMS). Indiana announced on July 30, 2026 that it will join. Our insurance coverage guide covers state Medicaid in more detail.

If you don’t qualify for the Bridge

The manufacturer savings offers that cut commercial copays to as little as $25 a month exclude people with government insurance, Medicare included. That leaves the self-pay prices in the table above, from $149 a month for the Wegovy pill or Foundayo starting doses to $449 for Zepbound’s higher doses with on-time refills.

Ask the pharmacy whether your Medicare enrollment affects a self-pay order before you buy. Our guide to GLP-1s without insurance compares the cash options.

The bottom line

Medicare covers Wegovy and Zepbound for weight loss in 2026 through the temporary GLP-1 Bridge: $50 a month for eligible Part D enrollees from July 1, 2026 to December 31, 2027, after prior authorization. Foundayo is covered too, and for Zepbound only the KwikPen is on the list.

If you use these drugs for sleep apnea, heart risk, MASH or diabetes, your regular Part D plan handles it instead. Bring your BMI and health history to a licensed clinician, ask whether you meet the Bridge criteria, and plan for the program’s scheduled end in December 2027.