Doctor Discussion Guide · Medicare GLP-1 Bridge Program
MedicareSelfEnroll.com
Bill Vargas · Independent Medicare Insurance Agent · Not affiliated with Medicare.gov
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Medicare GLP-1 Bridge
Doctor Discussion Guide

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Patient Information
Reason for This Conversation
Doctor, I would like to discuss whether I may qualify for the Medicare GLP-1 Bridge Program, which is scheduled to begin July 1, 2026. CMS states that a medical provider must submit a prescription and prior authorization request for an eligible GLP-1 medication. I would like to review my eligibility with you and ensure your office is prepared to submit the required authorization if I qualify.
Questions for My Doctor — Please Check Each One
Do I meet the medical criteria for the Medicare GLP-1 Bridge Program?
What was my BMI when I started GLP-1 treatment?
What qualifying conditions are documented in my medical record?
Does my current medication and formulation qualify under the Bridge Program?
Does your office know how to submit the required prior authorization for this program?
Who in your office handles prior authorizations?
Is any additional documentation needed from me?
Should I continue my current medication while awaiting approval?
Background Information for My Doctor

About the Medicare GLP-1 Bridge Program

CMS has announced a Medicare GLP-1 Bridge Program beginning July 1, 2026. Eligible Medicare beneficiaries may receive certain covered GLP-1 medications at a reduced monthly cost ($50 copay).

CMS states that a prescription and prior authorization request must be submitted by the medical provider. Prior authorizations will not be processed before July 1, 2026.

This program operates outside the standard Medicare Part D coverage flow. Please review my eligibility based on:

Obesity diagnosis on record
Starting BMI when GLP-1 therapy began
Qualifying medical conditions (e.g. hypertension, type 2 diabetes, sleep apnea, cardiovascular disease)
Treatment history and date therapy began
Current medication name and formulation eligibility
Notes from My Doctor
MedicareSelfEnroll.com
Bill Vargas · Independent Medicare Insurance Agent
Not affiliated with or endorsed by Medicare.gov or any government agency.
For updates: MedicareSelfEnroll.com/GLP1
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