Lilly: Medicare Covers Obesity Meds
Eli Lilly announces Medicare Part D patients may access Foundayo or Zepbound for weight management under the Medicare GLP-1 Bridge program for $50 per month starting July 1
1 We believe this is a milestone that reflects growing recognition of the impact of obesity, including in older adults. Below is what patients and their healthcare providers need to know, including an overview of the clinical and program eligibility requirements determined by Centers for Medicare & Medicaid Services (CMS). Are Foundayo (orforglipron) and Zepbound (tirzepatide) covered by Medicare through the GLP-1 Bridge program?
Medicare Part D patients who meet the Medicare GLP-1 Bridge Clinical Criteria and other CMS eligibility requirements may be able to access Foundayo (orforglipron) or Zepbound (tirzepatide) for weight management under the Medicare GLP-1 Bridge program for $50 per month. Other weight management medications are also covered under the program. Coverage begins July 1, 2026, for new and existing patients and will run through December 31, 2027. Foundayo (orforglipron) and Zepbound (tirzepatide) are indicated for adults with obesity, or some adults with overweight who also have weight-related medical problems, along with a reduced calorie diet and increased physical activity.
To learn more, visit For questions about the Medicare GLP-1 Bridge program, refer to Why is this a milestone for people on Medicare living with obesity? S. 2 Creating a Medicare Part D coverage pathway for eligible patients advances Lilly's long-held view of obesity as a chronic disease. It also unlocks access to Lilly's obesity medicines, offering patients and their doctors options rather than a one-size-fits-all approach.
"Lilly estimates that approximately 20 million Medicare patients may meet clinical criteria for obesity medicines, and starting July 1, eligible patients will be able to get Zepbound or Foundayo for $50 per month," said Ilya Yuffa, executive vice president and president of Lilly USA and Global Customer Capabilities. "For many, this will be the first time obesity treatment has been within reach. " How much do Foundayo (orforglipron) and Zepbound (tirzepatide) cost through the program?
Medicare Part D patients may be eligible for Foundayo or Zepbound for weight management for $50 a month, with a prior authorization and if they meet the Medicare GLP-1 Bridge Clinical Criteria and other CMS eligibility requirements. To learn more, visit What are Foundayo (orforglipron) and Zepbound (tirzepatide)? Foundayo (orforglipron) and Zepbound (tirzepatide) are two different Lilly medicines for chronic weight management, giving patients and their healthcare providers a choice of treatment options. Foundayo is a once-daily oral pill that can be taken any time of day, with no planning around food or drink.
S. Both are FDA-approved to help adults with obesity, or some adults with overweight who also have weight-related medical problems, lose excess body weight and keep it off, along with a reduced-calorie diet and increased physical activity. How do Foundayo (orforglipron) and Zepbound (tirzepatide) work in adults age 65 and older? In separate analyses of Phase 3 trials, both medicines were associated with meaningful weight loss in adults 65 and older, with safety profiles generally consistent with the overall study population.
In a post-hoc analysis of ATTAIN-1, adults 65 and older without type 2 diabetes, experienced an average weight loss of 13% when taking the highest dose of Foundayo. 8 "Obesity is a chronic, complex disease that deserves effective, long-term treatment options at every stage of life," said Rachel Batterham, senior vice president for Global Cardiometabolic Health at Lilly. " Who is eligible for these medicines through the Medicare GLP-1 Bridge program?
To qualify, a person must meet all of the Medicare GLP-1 Bridge Clinical Criteria and other CMS eligibility requirements when treatment is started:9 Be 18 years of age or older Have Medicare Part D drug coverage (not all plan types are covered)† Have a valid prescription, be using, or planning to use, Foundayo or Zepbound for weight management, alongside lifestyle modification consistent with the FDA approved labels Have a Body Mass Index (BMI) of 35 or higher, or a BMI of 27 or higher with certain weight-related medical conditions (or have had one before starting a GLP-1 medicine