Medicare GLP-1 Bridge Launches Wednesday July 1 (5 Days Out): Humana as Single Central Processor, Prior-Authorization Fax Line Goes Live July 1, Prescribers Do Not Need Medicare Enrollment, $50/Month for Foundayo, Wegovy (Injection and Tablets), and Zepbound KwikPen Through December 31, 2027
The Centers for Medicare & Medicaid Services' Medicare GLP-1 Bridge demonstration launches Wednesday July 1, 2026, five days from this digest's publication, providing eligible Medicare Part D beneficiaries with $50/month access to Foundayo (orforglipron), Wegovy (injection and 1.5/4/9/25 mg tablets), and Zepbound (KwikPen) for chronic weight management through December 31, 2027. Humana is the single central processor for prior authorization, claims adjudication, and pharmacy payment, operating outside of the standard Part D benefit's coverage and payment flow (Part D sponsors do not carry risk for eligible GLP-1 drugs under the Bridge). Two procedural details for prescribers: Medicare enrollment is not required to write a prescription or submit a prior-authorization request under the Bridge (the provider just cannot be on the Preclusion List), and prior-authorization requests will not be accepted or processed before July 1, when the prior-authorization form will be updated to include the fax submission number. Eligibility runs through three BMI tiers: BMI ≥35 with no additional requirement; BMI ≥30 with comorbid heart failure, uncontrolled hypertension, or chronic kidney disease; or BMI ≥27 with prediabetes, prior MI, prior stroke, or peripheral artery disease. The Bridge bridges to the broader BALANCE Model launching January 2027 in Medicare Part D.