Medicare offers pilot program that covers GLP-1 weight loss drugs

A recent Medicare change offers older Americans with obesity concerns a chance at affordable and possibly life-changing weight-loss drugs. The shift is particularly good news for rural Americans, who tend to be older and have higher obesity rates than their urban counterparts.

Beginning in July, Medicare beneficiaries "may be able to get a GLP-1 prescription for weight loss for $50 a month," reports Jackie Fortiér of KFF Health News. "It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments."

Although weight-loss drugs, such as Zepbound and Wegovy, offer chronically overweight patients a way to lose weight that may cause other health issues, their prices have often put them out of reach for many Medicare patients. Fortiér explains, "They’re available in injection or pill form. Even with discounts, current cash prices typically range from $149 to $699 per month."

In an effort to address Medicare enrollees' obesity-driven health problems and budgetary restraints, the Centers for Medicare & Medicaid Services announced a "short-term pilot program known as the Medicare GLP-1 Bridge. It will run from July 1, 2026, through Dec. 31, 2027," Fortiér writes. "It’s meant to 'bridge' the gap before a longer-term program that might — or might not — begin in 2028."

The pilot program will cover most GLP-1 weight loss medicines, including the pill and injectable formulations of Wegovy, the KwikPen formulation of Zepbound, and the Foundayo pill, Fortiér reports.

Medicare enrollees should know that Medicare's GLP-1 Bridge is "not your typical Medicare benefit. Even though Part D enrollment is required, the Bridge program itself works differently," Fortiér explains. "Instead of going through your regular Part D plan, you will need prior authorization" which your doctor can send to CMS for processing. Physicians prescribing GLP-1 to Medicare patients don't have to be, or become, registered Medicare providers.

Read all the requirements and rules for Medicare GLP-1 Bridge coverage here.

Military doctors try to replace therapy for PTSD with 'combat cocktails.' The practice has been linked to suicide risk.

Veterans are 50% more likely to commit suicide than civilian 
adults. (Medication-Induced Suicide Prevention graphic)

Although there is no data to support the practice, many military doctors prescribe "combat cocktails" to veterans with Post- traumatic stress disorder. "The practice, known as 'polypharmacy,' can tranquilize patients to the point of numbness, cause weight gain and increase suicidal thoughts when it involves pharmaceuticals that target the central nervous system," report Shalini Ramachandran and Betsy McKay of The Wall Street Journal. Because roughly a third of military veterans live in rural areas, the post-combat treatment may have a disproportionate impact on rural families and communities.

Medical guidelines for the Department of Veterans Affairs don't recommend giving patients simultaneous mixes of psychiatric medications, and the Food and Drug Administration warns against the practice. And yet, "prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD (post-traumatic stress disorder)," the Journal reports. "And the number of veterans on multiple psychiatric drugs is a growing concern at the agency."

Polypharmacy definitions vary, but "the VA defines it as taking five or more medications at the same time," Ramachandran and McKay explain. A growing number of VA physicians and researchers believes such dosing can have disastrous results, because powerful drugs can interact with patients' nervous systems and each other in unpredictable ways.

While talk therapy is considered the best PTSD treatment, therapists are often in short supply, so medical providers have turned to medicine to treat PTSD symptoms. "Nearly 60% of VA patients with PTSD were taking two or more central nervous system drugs at the same time in 2019," the Journal reports. "The VA declined requests from The Wall Street Journal to provide more recent polypharmacy numbers for veterans in its care."

Given that suicide rates among veterans are much higher than those of civilian adults, how the VA treats PTSD is under scrutiny from Congress, advocacy groups and veterans. "Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans," Ramachandran and McKay write. "Yet the agency has been slow to mandate changes."