The Medicare GLP-1 Bridge
starts July 1.
Eligible Medicare beneficiaries can now access Wegovy, Zepbound, and Foundayo for $50/month. That means more patients at your door - and a prior authorization process your clinic may not be set up for yet.
Adherix helps clinics navigate Bridge enrollment and keeps those patients on treatment once access is granted.
What providers need to know
The Bridge operates outside the standard Part D benefit. Providers submit prior authorization through a new central processor - not the patient’s existing plan. Here is what that means operationally.
Prior authorization
PAs are submitted to a single central processor - not the patient’s Part D plan. CMS accepts requests electronically or by fax. The PA form is being released June 2026.
Patient eligibility
Patients must be enrolled in Medicare Part D (PDP or MA-PD). They must meet BMI thresholds and have at least one qualifying condition: heart failure, hypertension, CKD, pre-diabetes, or cardiovascular history.
Provider attestation
The PA must attest that the drug is prescribed for weight reduction in combination with ongoing lifestyle modification - structured nutrition and physical activity per FDA labeling.
Covered medications
Wegovy (injection and tablets), Zepbound KwikPen, and Foundayo are covered under the Bridge for weight management. $50 copay per month. Does not count toward Part D out-of-pocket limits.
We help clinics operationalize the Bridge
Navigating a new federal program on top of an already full patient panel is a real operational lift. Adherix works alongside your team to make sure Bridge patients get enrolled and onboarded without adding staff overhead.
PA documentation review
We walk through your documentation workflow and identify gaps before the July 1 launch - so your first PA submissions go through cleanly.
Patient eligibility screening
We help you identify which patients in your panel likely qualify for the Bridge so you can prioritize outreach before demand surges.
Onboarding workflow setup
We map the patient journey from eligibility confirmation to first prescription - so your front desk and clinical staff know exactly what happens when.
Staff readiness checklist
A practical checklist your team can run through before July 1 - covering PA submission, patient communication, and documentation filing.
Getting patients enrolled is step one. Keeping them on treatment is where the work begins.
GLP-1 dropout rates are highest in the first 90 days - before patients see meaningful results and while side effects are most disruptive. The Bridge gets your patients access. Adherix Keep makes sure they actually use it.
- Phase-based SMS engagement from day one
- Automated drift detection when patients go silent
- Side effect check-ins timed to dose escalation windows
- Injection confirmation tracking for real adherence data
- Clinic alerts when patients need a human touchpoint
* Modeled estimates based on published GLP-1 adherence data.
Provider resources
Official CMS materials and Adherix support documents for Bridge-eligible clinics.
Official CMS documents
Adherix templates
Clinic Bridge readiness checklist
PA submission, patient identification, staff training, and post-enrollment follow-up - all in one pre-launch checklist.
Bridge patient onboarding workflow
Step-by-step from eligibility screening to first prescription - mapped for front desk and clinical staff.
The Bridge opens a door.
Make sure your clinic is ready to walk through it.
We offer a free workflow review for clinics preparing for the July 1 launch - covering PA readiness, patient identification, and post-enrollment support.
Book a free workflow review