Not eligible for the Medicare GLP-1 Bridge: what you pay instead
After a Bridge denial, Medicare pays nothing toward a GLP-1 for weight loss and you pay cash. The makers' own prices run from $149 a month for Foundayo at 0.8mg to $449 for the Zepbound vial at 7.5mg to 15mg, when you refill within 45 days of your last delivery.
If the Bridge turned you down, two cash programs to check.
- Strut Health$149 a month, with auto-refillcompounded semaglutide, not FDA-approvedCheck price →
- Shed$199 a monthcompounded semaglutide, not FDA-approvedCheck price →
The four reasons people are turned down
- No band fits. A BMI under 27, or under 35 without a listed condition. The BMI chart shows the weight for your height.
- A diagnosis Part D can cover. Type 2 diabetes, moderate to severe sleep apnea or MASH sends the request to your Part D plan instead. How that route works.
- The wrong plan type. Private fee-for-service, cost plans, PACE and three others are out unless you also hold a standalone drug plan. Which plans count.
- The wrong product. A prescription for a Zepbound vial or single-dose pen is denied. Ask for the KwikPen by name.
The last two are fixable. A standalone drug plan or a KwikPen prescription can put you back in. The first two are not.
What the makers charge in cash
| Drug | Lowest price | Highest price |
|---|---|---|
| Wegovy pen | $199 (0.25mg and 0.5mg, first two fills; new patients, through December 31, 2026) | $399 (7.2mg, Wegovy HD) |
| Zepbound vial | $299 (2.5mg; when you refill within 45 days of your last delivery) | $449 (7.5mg to 15mg; when you refill within 45 days of your last delivery) |
| Foundayo | $149 (0.8mg) | $299 (9mg) |
The makers' self-pay prices as listed on TrumpRx, read September 10, 2026. Novo Nordisk sells through a coupon at your pharmacy and Lilly through LillyDirect.
Every maker offer on TrumpRx is for people paying cash. You agree not to bill Medicare for the fill or count it toward your out-of-pocket limit. The Wegovy pill is not in the table: Novo Nordisk's self-pay offer for it excludes government beneficiaries, and Medicare members are among them.
The dose you stay on decides what a year costs. The chart prices every program at that dose.
Frequently asked questions
Does Medicare pay anything if I do not qualify for the Bridge?
Not for weight loss. Part D is barred by law from covering a drug used for weight loss, and the Bridge is the only way around that. Part D plans can cover a GLP-1 for type 2 diabetes, sleep apnea, MASH and heart risk.
Can I use a manufacturer savings card on Medicare?
No. The Wegovy, Zepbound, Ozempic, Mounjaro and Foundayo cards all exclude Medicare and every other government plan.
Can I appeal a Bridge denial?
No. Your prescriber can send the form again with corrected or new information. If no band fits, a new form will not change the answer.
GLP Chart is an independent comparison site, not a pharmacy and not a medical provider. Confirm the rules with your prescriber and your plan before your next fill.
