Prior authorizations are required because they determine a patient's eligibility for the Medicare GLP-1 Bridge.
The Medicare GLP-1 Bridge was designed to increase access to GLP-1 medications for patients who use the drug solely to reduce excess body weight or maintain their reduced weight. The approval process confirms whether you qualify for the Medicare GLP-1 Bridge Program. This program was specifically created for people who are using GLP-1 medications for weight loss only.
Is This Program Right for You?
It depends on why your doctor prescribed the medication.
| Your GLP-1 is prescribed for... | Where to get it |
|---|---|
| Weight loss or weight management | Medicare GLP-1 Bridge Program ($50/month) |
| Type 2 diabetes | Your regular Medicare drug plan |
| Sleep apnea | Your regular Medicare drug plan |
| A liver condition called MASH | Your regular Medicare drug plan |
If your GLP-1 is prescribed for diabetes, sleep apnea, or MASH, you can still get the medication — but through your regular Medicare drug plan, not this program. Your normal plan costs will apply instead of the $50 copay.