Medicare GLP-1 Program Begins July 1

Beginning July 1, 2026 through Dec. 31, 2027, Medicare beneficiaries with Part D coverage may be eligible to access certain GLP-1 medications for $50 per month.

To access GLP-1 medications through the demonstration program, an eligible beneficiary must have a medical provider submit a prior authorization request and a prescription for an eligible GLP-1 drug for a covered use. CMS will provide additional information on prior authorization processes in Spring 2026.

Additional information, including patient eligibility criteria and drugs that will be available through the program, are available here.

As previously reported by ACOI, the GLP-1 demonstration is a bridge to the Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model that will combine access to GLP-1 medications with access to evidence-based lifestyle supports to achieve better long-term health outcomes.