Medicare’s new GLP-1 Bridge Program gives eligible retirees access to Wegovy and Zepbound for $50 a month — but there are three financial catches worth knowing before you enroll.

In this episode of the Secure Your Retirement Podcast, Radon and Murs discuss one of the biggest Medicare developments of 2026 — the new GLP-1 Bridge Program, launching July 1, which allows eligible Medicare beneficiaries to access popular GLP-1 weight loss medications like Wegovy and Zepbound for a flat $50 copay per month. Joined by Peace of Mind Wealth Management’s in-house Medicare specialist Shawn Southard, they break down exactly what this program is, who qualifies, how the approval process works, and what the financial implications look like for retirees on fixed incomes.

Listen in to learn about the three financial angles every retiree needs to understand before enrolling in the GLP-1 Bridge Program, including why that $50 copay sits completely outside your normal Medicare Part D protections, what happens when the program ends in December 2027, and how GLP-1 medications and Medicare prescription drug coverage fit into a broader retirement planning conversation around healthcare costs, budgeting, and long-term affordability.

In this episode, find out:

• What GLP-1 medications are, why Medicare historically excluded them for weight loss, and what changed in 2026 to make the GLP-1 Bridge Program possible
• Who qualifies for the program based on BMI and health conditions, and how your doctor submits a prior authorization request through Medicare’s centralized system
• Why the $50 flat copay does not count toward your Medicare Part D deductible or annual out-of-pocket maximum, and what that means for your retirement budget
• What retirees need to plan for when the program’s temporary status ends in December 2027 and costs could jump significantly
• The health considerations and side effects of GLP-1 medications that matter most for older adults, and why this conversation belongs with your doctor and your financial planner

Tweetable Quotes:

“Retirees need to avoid assuming that this benefit program is going to be permanent forever. Plan for what happens if that $50 copay jumps back up to several hundred dollars a month.” — Murs Tariq

“This is both a healthcare conversation and a financial planning conversation. Retirees should evaluate long-term affordability, potential future coverage changes, and how chronic disease management fits into an overall retirement plan.” — Shawn Southard

Resources:

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To access the course, simply visit POMWealth.net/podcast.

Here’s the full transcript:

Welcome back to the Secure Your Retirement Podcast, and thanks for tuning in on this Monday. For 

this podcast episode, we’re going to break down a Medicare topic that may have some impact on your 

retirement, your finances, and your peace of mind. Today we’re talking about one of the biggest 

healthcare stories of 2026, and you know it’s been evolving over the years, this topic of GLP-1s, 

Medicare’s new temporary program that could allow eligible beneficiaries to access popular GLP-1 

weight loss medications like Wegovy, and ZepBound for a very subsidized cost at around $50 a month. 

They’ve become household names over the last few years. They’ve helped with weight loss, but also 

other types of issues not directly correlated with weight loss, but they’ve been very expensive to 

get access to, so Medicare is changing that a little bit for us. Now, that’s about as far as I can 

get without introducing Shawn Southard. A lot of you have heard of Shawn on our podcast before. 

He’s our in-house Medicare and medical pre-Medicare insurance as well. 

He’s our specialist when it comes to all of that world. And so, if I was to try to talk any more 

about this, I would be struggling quite a bit. But that’s why we have Shawn. 

Shawn pays attention to what’s going on in the healthcare space, the Medicare space, and then pretty 

cool things like this, this topic we’re going to talk about. It’s nice to have him as the expert. 

So, Shawn, welcome back, and thanks for joining me today. Hey, thanks, Murs. I really appreciate the 

opportunity to be here today. 

So, let’s do this, Shawn. We’re going to break this down kind of step-by-step for our listeners, 

but let’s just start with what is the Medicare GLP-1 Bridge Program, 

and tell us a little bit about that, and then we’ll talk more about what is GLP-1s, and why does 

everybody wants them, and why is it such a cool thing? Yeah, no, absolutely. So, yeah. So, as you had 

mentioned, this is a pretty significant change in Medicare. It’s a really significant policy 

development. It’s been years, you know, coming and it really touches base on a lot of different 

areas, you know, health care access, chronic disease management, prescription drug spending, 

and health care retirement budgeting, you know, all kind of in one fell swoop. There’s a lot of 

confusion out there about, I mean, as we’ve talked about before, 

they should rename Medicare to Muddlecare, right? It’s so complex and confusing sometimes. So, I’m 

glad I can be here today for a little bit and talk with you and through this for our listeners. 

So GLP-1, it’s called the GLP-1 Bridge Program. 

So, you know, what is that? So that’s an initiative. It’s temporary, 

right? They’re calling it a Medicare demonstration. CMS has announced this. 

CMS is an acronym for the Centers for Medicare and Medicaid Services. So, CMS has announced this GLP 

-1 bridge program. It’s starting July 1st, 2026, so it’s right around the corner. 

It’s less than three weeks away. And you have to qualify. You have to be eligible for it. 

So eligible Medicare beneficiaries through this program are going to be able to obtain certain GLP 

-1 medications that have been approved for weight loss and get that medication for $50 flat every 

month. And the program is currently scheduled to run through December 31st of 2027, 

so, a year and a half. And once again, it’s really important because Medicare historically has not 

covered these GLP-1 medications that have been described for people solely for obesity or weight 

loss. So, it’s a huge development. Right. I mean, when all these products started to come out a few 

years ago, the GLP-1s and the Wegovis and the other brands out there, it was kind of more catered 

to the… the higher net worth that could afford the thousands of dollars a month and for weight 

loss. So, this seems like a significant shift. In my eyes, Medicare is just there to kind of make 

sure, we take care of the needs of taking care of ourselves, but nothing beyond that, 

right? It’s not to help you lose weight to look better. That’s not what Medicare is for. 

Medicare is there to just kind of take care of you in a lot of other areas of focus. So, this is a 

pretty significant shift. So why now? What’s Medicare seeing in GOP-1s? 

Yeah, so, you know, as we mentioned, you know, Medicare for a long time, you know, 

had rules that excluded these drugs for weight loss um you know there were a lot of safety 

concerns and so forth with earlier versions of these types of drugs but they have found that 

glp1 drugs have really changed the whole conversation that’s out there around it because 

they’ve shown meaningful results for weight reduction um you know in addition to you know well 

management for diabetics, cardiovascular reduction events, and other metabolic conditions that 

exist for people out there. So, they’re really finding that the GLP wands are doing so many great 

things for people. And I think that’s really what’s the major shift in their focus, which is 

wonderful. Yeah, I think that is wonderful. I’ve heard more and more of clients talking to us about 

going on it, not for… loss scenarios but just to help kind of regulate some other systems and 

that that’s a nice byproduct of what initially was intended to be a weight loss drug now it’s 

turning into way more than that so it would make sense that Medicare sees the benefit of if we can 

get diabetes and some of these other things under control well then inherently costs start to go 

down across the board um okay so we’ve talked about glp ones but just for the you know our 

listeners, let’s just talk about, well, what are GOP-1 drugs? And what’s their purpose for the 

ones that maybe aren’t following or paying attention to the pharmaceutical world? Because it’s such 

an exciting space that everyone watches and listens about pharmaceuticals, right? So, what are GOP 

-1s? So, trying to keep this kindergarten simple, as they always say. 

So, for our listeners out there, so GLP-1 drugs, they’re medications and they mimic hormones in 

your body that regulates your appetite and your blood sugar levels. Okay, that’s what they’re 

designed to do. And some of the best known GLP-1s out there are Wagovi, 

Zepbound, Ozempic, Mongero, and Foundeo. 

And so just for the listeners, this particular… program, this BIDG program, the GLP-1 BIDG 

program, it’s going to utilize three of those five. It’s the three that are going to be involved 

are Fondeo, Wagobe, and Zeppown, and they would have to be the quick pen version. 

There are other versions that you can get of the drug to administer yourself. You know, you could do 

tablets, you can do, you know, other ways, but you’re going to have to do the quick pen version as 

part of this program. And of course, these medications, when taken, help people feel fuller for 

longer periods of time. Like they’re not going to be as hungry as they normally would be. It 

reduces the appetite urges and improves your blood sugar control and your blood sugar levels. 

And in many, many cases, as we know, produces significant. and substantial weight loss for people. 

And then, of course, clinical studies over the years have shown that many patients lose 15% or 

more of their body weight while they take these medications on a consistent basis. Yeah, 

I’ve seen firsthand how it works in my friend group and family and things like that, 

that it does help quite a bit with the desire for weight loss just by being able to curb that 

appetite. But you know, it’s been… battle that a lot of people have had that I’ve seen and that 

you read about and hear about is while it seems like a tremendous drug and a solution, it’s also 

very expensive. 

No, it is exactly, Murs. So, you know, without insurance coverage, if you don’t have insurance and 

it’s not covered, so for Medicare beneficiaries, as we know, it’s not covered for weight loss and 

obesity specifically. These GLP-1 meds are often… They can cost anywhere from a several hundred 

dollars to over thousands of dollars a month for people to have them based on the dosage that they 

take and the formulations that they need. And even discount programs that do exist out there 

through GoodRx and different things like that still leaves people hanging and having to pay 

hundreds and hundreds of dollars for it. So, the one reason why this whole program is so wonderful 

is it’s going to help people out financially. Yeah, so you mentioned it earlier, 

if you qualify, right? The Medicare, they throw those words around so often of if you qualify for 

this. So, who actually can qualify for this GLP-1 bridge program that you’re talking about and how 

does that work? Yeah, so it’s, once again, we’ll get into the middle of the muddle care part here. 

Good thought. So, who qualifies? So first, the person must be enrolled in a Medicare Part D 

standalone prescription drug plan or a Medicare Advantage plan with drug coverage, 

which is known as an MAPD, Medicare Advantage Prescription Drug Plan. So, if you’re in one of those, 

you’re stepping in the right direction. And then eligibility from there is going to be based on 

your BMI, your body mass index, and some other health conditions that are going to be out there. 

So generally, in a general sense, individuals with a BMI of 35 or higher are going to automatically 

qualify for the program. Individuals with a BMI of 27 or higher may qualify if they have conditions 

such as prediabetes, cardiovascular disease, 

peripheral artery disease, prior stroke history, or similar other health risk factors. 

thing to remember here, I guess a nuance is that if someone has already started treatment 

previously with their provider and have successfully lost weight, their doctor may still be able to 

write up and document that and that can make them eligible for the program. 

So that’s something to keep in mind. Yeah, it’s kind of a catch-22 of, 

well, the drug itself is going to help someone. in all essence, 

reduce their BMI through fat loss and weight loss. And they could get to a point where they no 

longer qualify, but maybe, so I guess what you’re saying is maybe the doctor still believes they 

need to be on it, even though they’re out of qualification to just kind of get into this place of 

maintenance. Is that kind of what you’re saying there? Yeah, spot on, spot on, 

so yes, so Centers for Medicare and Medicaid Services, CMS, obviously it looks like they, 

it appears to recognize that obesity treatment is ongoing, it’s an ongoing thing, and it’s not 

simply an anecdotal or a short-term event, so that’s something that’s, that’s good and positive 

and hopeful. Yeah, okay, so, so Shawn, then how does this program work in, 

in aspect to like normal Medicare? Drug coverage and stuff how does this work how do you get 

access what’s the process look like right no a good question so yeah, so it’s a little 

unusual so the program is operating outside the standard part d structure if you will so um 

so, what happens is doctors must submit a prior authorization request through the centralized CMS 

processing system that CMS has set up, and the CMS has chosen a vendor called humana People are 

probably very familiar with the insurance carrier known as Humana. They’ve been chosen by CMS to be 

the conduit, if you will, and the administrator of all this. And they’re going to serve as a 

central processor for approvals and all the claims management that goes along with it. So once a 

person is approved through all this. The patient will be able to receive the GLP-1 drug for a flat 

$50 copay at their pharmacy where they get their medications filled. 

And that’s where I think where you said earlier that it’s a huge financial benefit to the people 

that need it and want to be on it because it’s a flat copay, right? So, in my experience of medicine 

in general, the more you need of it, the more it’s going to cost. And the dosage when it comes to 

these GOP-1s is going to be dependent on a lot of different factors. But you’re saying it’s a flat 

copay regardless of dosage. Yeah, regardless of the dosage, it’s going to be a strict flat copay of 

$50. So, a really attractive feature here is predictability. And, 

of course, just in the normal course of things, people, beneficiaries that are moving to higher 

doses can often face dramatically higher pricing. But under this program, 

everything is going to be set at $50 flat, no matter what the dosage ends up being. 

So, retirees on fixed incomes, predictability matters just almost as much as affordability. 

Okay, well, great. Well, it all sounds pretty good so far. I mean, taking a somewhat of a miracle 

type of drug and bringing it to where it’s accessible to really anyone that qualifies at a copay 

that’s not much different than most of the drugs that they’re paying for. So, let’s tie this back in 

because after all, we are a financial planning firm. And Medicare, we believe, is one of those 

critical areas of financial planning success. But there’s other areas, too. So, you know, 

how should retirees think about this financially? Yeah. So, try not to be super long winded here, 

but that’s a that’s a great question. Fair question. And, you know, and what I’ve been thinking 

through all this. So, I think there’s really three important angles to consider with all this. 

So, as we all know. probably should know at this point, you know, healthcare in and of itself 

remains one of the largest retirement expenses that retirees face. And one of the largest asset 

managers and brokerage firms in the U.S. called Fidelity has studied a lot of this and has 

estimated that on average, retiree couples may need hundreds of thousands of dollars to $250,000, 

$300,000 plus. to help cover health care expenses over the course of their retirement. 

So, you know, when all this is coming up, people are probably going to ask, 

well, should I budget, you know, for this type of thing, this GLP-1 thing, you know, long term? 

And this is where we need to throw some caution out there, right? So, with health care inflation. 

And then second, remember that this program, as I mentioned earlier at the beginning, It’s 

temporary. It’s only currently slated to last until December of 2027 under the current rules. 

So even though studies, you know, are showing and demonstrating that patients… 

They also often regain significant weight after stopping GLP-1 therapy. So, retirees need to avoid, 

you know, or be cautioned to not assume that this benefit program is going to be permanent forever 

into the future. So that really boils down to planning. You know, 

what should we do as far as planning, right? So, what happens if my GLP-1 meds suddenly jump from 

$50 flat copay? back up to several hundred dollars or thousand dollars a month. 

You’ve got to factor that in because that could absolutely happen with the temporary status of this 

program. And then lastly, third, the co-pays do not count towards any Part D spending caps that 

are part of the Part D plans in Medicare, whether it’s on a Medicare Advantage plan or standalone 

plans. And this surprises many people. So, remember that $50 co-pay that you’re going to pay for 

the GLP-1, from my understanding of this whole program. the BITS program, it’s not going to count 

towards your deductible of your prescription drug plans in Medicare, and it’s not going to count 

towards the annual pocket, that maximum out-of-pocket limits on those plans. So financially, 

these expenses are going to sit outside the normal Medicare prescription drug costs and protections 

that are in place. Well, that’s an interesting point, Tom, because I think a lot of people in 

Medicare and on prescriptions probably… You know, with the normal prescriptions that they take, 

they’ll probably hit their cap on Part D and not have to worry too much about cost from there on 

out. But you’re saying this is outside of the caps for co-pays under Part D. 

So that seems rather odd, but you can kind of justify it a little bit because it’s a rather 

expensive drug that they’re subsidizing significantly. 

But I think it’s an important nuance for people to understand. No, absolutely, and very much so. 

And even for folks that get extra help, Medicare extra help, for folks out there listening to the 

podcast and people on the podcast who know folks in this category receiving Medicare extra help, 

any subsidies that that person is receiving through that program cannot apply towards this either, 

this bridge program. So those folks that are on extra help, if somehow it doesn’t remain in place, 

you know, that $50 a month is going to be tough, can be tough for some folks out there. 

So, it’s just something to be cognizant of and aware of as far as, you know, planning and looking at 

all this. So, and normally when I do these podcasts, Sean, I give disclosures about us 

providing investment advice and know that we are not making any specific recommendations and stuff 

on here. But we’re not talking about investments today. We’re talking about health care and a very 

specific drug. And so, what I what I feel like we should do a little bit is because it sounds like 

we’re kind of pushing it and saying, hey, go. Go get it. It’s a good deal if you need to lose some 

weight. But there’s considerations and health risks. And what everyone here needs to understand as 

well, that’s listening is Sean is not a health care professional. He’s not a doctor. 

He’s not a researcher in pharmaceutical. He’s a Medicare expert in our firm. 

But he knows a lot about this stuff. So, from what you’ve done as far as researching and 

understanding GOP-1s, what are some of the drawbacks just so listeners kind of know it’s not the 

perfect thing out there? Yeah, no, thanks. So, for those listening, yes, I’m not a medical 

doctor. I did not go to medical school. I’m not, I don’t work in the pharmaceutical industry. 

I’m not a pharmaceutical professional by any stretch of the imagination. 

I’m a licensed insurance. Healthcare professional specializing in Medicare and under 65, 

you know, programs for health insurance for people. But always staying on top of things and trying 

to be the best healthcare resource I can be for the clients of Peace of Mind Wealth Management and 

any person I get a chance and privilege to work with. So, with all that being said, 

you know, remember that TLP1s are not risk-free, okay? So, they can be very effective, 

but they also have some side effects, right? So, some common side effects that have been 

demonstrated, people that are taking these, you know, nausea, vomiting, diarrhea, 

constipation, dehydration, just to list some starters. And of course, 

you know, as we age, dehydration is really critical for seniors because it increases fall risk, 

increases dizziness and vertigo, kidney complications, and interaction with other medications that 

people may be taking. So, there’s really, you know, there’s also a concern that rapid weight loss in 

older adults can also reduce muscle mass. not just, you know, the fat mass. 

So, you know, the loss of that muscle, that lean muscle mass can affect a person’s strength and 

mobility, you know, as they age. So, you got to be cognizant of that. So bottom line, talk to your doctor, talk to your healthcare professional, 

see if it’s right for you. And then the advantage here, I think you said July is when this program 

starts. july is when this program starts and it may you may become eligible for it 

if you’re on Medicare, we’ve talked about part d here son but let’s talk a little bit about Medicare 

advantage because that’s another popular option in the Medicare space how’s it going to work on 

Mediare advantage yeah so how it’s going to work there what from what I can see and what I what 

what I’ve read about. So, Medicare Advantage plans, as people may or may not know, because of how 

they’re structured; they do provide some extra perks that Original Medicare doesn’t have. Many of 

them can provide some broader wellness programs, like working with professionals to help with 

physical wellness, nutritional counseling, and chronic disease support. 

So that’s good there. But under the bridge program, the GLP-1 bridge program itself, 

CMS is essentially bypassing the normal insurer structure, remember, 

and using a centralized administration process through the carrier known as Humana. 

So long term, even though insurers are watching all this very closely, because we know widespread 

GLP-1 usage could dramatically affect Medicaid. costs in the positive, 

cutting down on all the chronic diseases and so forth that are coming out of being overweight and 

being obese. Sometimes the estimates that we see suggest that expanded obesity drug coverage could 

cost Medicare tens of billions of dollars over time. So, they’re going to have to weigh all this out 

and see what makes the most sense. Right. Absolutely. And so, as we come to a close here, 

just a quick reminder that this program goes in place in July. And then it’s a bridge program that 

currently is set to work until the end of 2027. And based on my conversation with Sean, 

we just don’t know what’s going to happen after 2027. So, it’s not a permanent plan yet. 

Could it become permanent? Maybe. Could they see the benefits of it, of reducing more than just 

obesity, but helping with? heart issues and diabetes and things like that and make it a permanent 

policy, we don’t know. So, for right now, it’s a short-term plan to get things on track. But Shawn, 

my final kind of question to you to kind of bring it all home, summarize it. For our retirees 

listening today, what are the key points you want them to take away after listening to us for, you 

know, 30 minutes or so? Yeah, exactly. So, we appreciate everybody hanging in there with us today 

and listening to this podcast. So, I’d like to just kind of hit on four things, 

four simple things, kindergarten simple, right? So, number one, remember that this program is 

potentially life-changing for many Medicare beneficiaries who previously could not afford the GLP 

-1 medications. Number two, the program is, remember, is temporary. It’s a temporary pilot program. 

It’s not guaranteed to be enforced permanently. Number three, these GLP-1 meds can have meaningful 

health benefits for people, but they also require thoughtful medical supervision through your 

doctor and medical providers, especially for our older listeners and our seniors on the podcast. 

And lastly, number four, this is, remember, both a health care conversation and a financial 

planning conversation to have with your financial planners. Remember that retirees should evaluate 

long-term affordability, potential future cover changes, health care budgeting, and how chronic 

disease management fits into an overall retirement planning scheme. All right. 

Well, I think that wraps it up really nicely there, Sean. As always, we encourage you, 

if you’ve got questions from… conversation that Shawn and I just had, whether it’s on the Medicare 

side of things and you’ve got questions and you want to talk to Shawn, or you heard him say that 

this incorporates with financial planning and maybe you don’t have someone that helps you with that 

as well. We are always open to have those conversations. The easiest way to do so is hop over to 

our website, pomwealth.net, and there’s a contact us button where you can schedule a call with one 

of our advisors and we’ll help direct you the right way. If you want to get in touch with Shawn, 

directly, call our office, 919-787-8866, and say, I heard about that guy named Shawn on 

Medicare on your podcast, and I really would like to have a conversation with him. And our team 

will get you set up with him as well. He’s a wealth of knowledge. If you’ve been listening, you 

know that’s a fact. But as always, Shawn thank you for hopping on with me today. And thank you all 

listeners for hanging out with us for a little bit of time here on Monday. And we will talk to you 

again, next Monday. Take care.