Starting July 1st, 2026, the Centers for Medicare & Medicaid (CMS) announced it's launching the pilot program Medicare GLP-1 Bridge to provide a weight-loss coverage pathway for eligible patients, which will run through December 31st, 2027. 

Here is a summary of the new process: 

• Verify Bridge eligibility before submitting a prescription, including Part D enrollment, weight management use, clinical criteria listed below and applicable exclusions.
• Send the prescription to the member’s pharmacy with an E66 obesity diagnosis code and “SEND TO BRIDGE FOR WEIGHT MANAGEMENT” in the notes. 
• Initially, the claim will reject to establish an eligibility record with the Bridge program followed by next steps for the required prior authorization.
• When prompted, submit the prior authorization by electronic prior authorization, or ePA, or fax to Humana, the central processor CMS has selected for Bridge.
• The decision will be communicated within 72 hours.

Click here to learn more about patient eligibility, prior authorization workflow, and other details of this new program.