Medicare clarifies GLP-1 coverage 'bridge period' policy for weight-loss patients

CMS has published new guidance detailing a 'bridge period' coverage policy for Medicare beneficiaries on GLP-1 drugs for weight loss who lose coverage due to plan changes or loss of supplemental insurance. The policy allows for temporary continued coverage under specific, limited circumstances to prevent abrupt medication cessation. The operational details, including duration and eligibility verification steps, are now available. For practices managing Medicare patients on drugs like Wegovy or Zepbound, this changes the prior-authorization workflow. Starting now, you must verify a patient's bridge-period status through the Medicare Plan Finder or by contacting the prescription drug plan directly before submitting new PA requests or refills. Update your front-desk checklist for Medicare patients on GLP-1s to include this new status check to avoid unnecessary denials during transitions.