Medicare's GLP-1 Bridge program covers Foundayo and Zepbound at $50 a month
Eli Lilly says eligible Medicare Part D patients can get the Foundayo pill or Zepbound injection for weight management at $50 a month, starting July 1, 2026.
Eli Lilly has laid out how a new Medicare coverage pathway, the Medicare GLP-1 Bridge program, will work when it starts on July 1, 2026. Under it, eligible Medicare Part D patients can get Foundayo (orforglipron), a once-daily pill, or Zepbound (tirzepatide), an injection, for weight management at $50 a month. Lilly says it is the first time eligible Part D patients will be able to broadly get a GLP-1 covered for overweight or obesity. The eligibility rules are set by the Centers for Medicare and Medicaid Services (CMS).
What the program covers
Patients who meet the program’s clinical criteria and the other CMS requirements can get Foundayo or Zepbound for weight management at $50 a month, with a prior authorization. Lilly says other weight management medicines are covered under the program too. Coverage runs from July 1, 2026 through December 31, 2027, for both new and existing patients. Lilly estimates that around 20 million Medicare patients may meet the clinical criteria.
Who qualifies
To qualify when treatment starts, the program says a person must:
- Be 18 or older.
- Have Medicare Part D drug coverage, and not every plan type is included.
- Have a valid prescription for Foundayo or Zepbound for weight management, used alongside the lifestyle changes described in the FDA labels.
- Have a BMI of 35 or higher, or a BMI of 27 or higher with certain weight-related conditions, or have had one of those before starting a GLP-1.
Lilly says patients who already get a GLP-1 through their Part D plan are not eligible, and neither are patients with type 2 diabetes, moderate-to-severe obstructive sleep apnea, or fatty liver disease, since a Part D plan may already cover those conditions.
How to get started
From July 1, 2026, Lilly describes five steps. Talk with a healthcare provider about whether Foundayo or Zepbound is right for you. Have the provider send a prescription to LillyDirect Pharmacy or a retail pharmacy of your choice. Work with that pharmacy. Have the provider complete a prior authorization. Once it is approved, you pay $50 a month.
What the two medicines are
Foundayo is a once-daily oral pill that can be taken any time of day with no planning around food or drink. Zepbound is an injection that Lilly describes as the most prescribed injectable weight management medicine in the U.S. Both are FDA-approved for adults with obesity, or some adults with overweight who also have a weight-related condition, alongside a reduced-calorie diet and more physical activity.
Worth knowing
Foundayo and Zepbound are prescription medicines, and whether either one is appropriate, the dose, and the risks and side effects are matters for the label and a prescriber. Their labels carry a warning about the risk of thyroid tumors, including thyroid cancer. The coverage, cost, and eligibility details here come from Lilly and CMS.
General information, not medical advice. Care decisions are between you and a licensed prescriber.