By admin 
PHOENIX (AZFamily) — Medicare began covering weight-loss drugs for millions of Americans Wednesday for the first time, through a new pilot program approved by the Centers for Medicare and Medicaid Services.
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“This is really a first-time historic event,” Dr. Doug Maready said. He is the Arizona Obesity Organization President and Chief Medical Officer of Forte-Well Being. “It’s going to add millions of people to coverage eligibility.”
The program, called the Medicare GLP-1 Bridge, runs through the end of 2027. Historically, law has banned Medicare from covering weight-loss medications.
“It’s not changing the law, but it’s offering people with Medicare who might be eligible temporary coverage for these medications for weight loss,” Dr. Juliette Cubanski, vice president and director of the Program on Medicare Policy at KFF, said.
The Bridge program allows eligible enrollees access to approved drugs for a $50 monthly co-pay.
Who is eligible
To qualify, patients must have a body mass index of 35 or higher. Those with a BMI below that threshold may still be eligible if they have certain conditions, including heart failure, uncontrolled high blood pressure, chronic kidney disease or prediabetes.
Patients are not eligible if Medicare already covers their GLP-1 medication for Type 2 diabetes, sleep apnea or fatty liver disease.
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What drugs are covered
The three medications available through the Bridge program are Foundayo, Wegovy and Zepbound. Without insurance, those drugs can cost between $1,000 and $1,500 per month out of pocket, according to obesity medicine physician Dr. Krystal Tamura.
What doctors are saying
According to physicians, the goal of the Bridge program is to determine whether preventive care that treats obesity before it becomes another disease can reduce long-term costs.
“Medicare taking this on is a huge step because most of our other companies will follow suit once Medicare decides they want to do coverage,” Tamura said.
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