BMI 27: which tier am I in?
Short answer: A BMI of 27 to 29.9 puts you in reach of the Medicare GLP-1 Bridge's Tier 3: you qualify if you also have prediabetes, a previous heart attack or stroke, or peripheral artery disease with symptoms. BMI 27 is about 167 pounds at 5'6", 178 at 5'8", or 188 at 5'10".
Program facts last verified against CMS: July 21, 2026
What BMI 27 looks like
BMI 27 sits in the 'overweight' range — not obesity. Examples: 5'4" at 157 lbs, 5'6" at 167 lbs, 5'8" at 178 lbs, 5'10" at 188 lbs, 6'0" at 199 lbs. Many people at these weights assume prescription weight-loss coverage isn't aimed at them; at this program's Tier 3, it is — provided one qualifying condition is present.
The most commonly held qualifying condition by far is prediabetes, which affects roughly half of adults over 65 and usually has no symptoms. A routine A1c blood test is the way to find out.
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Common questions
Can I qualify at BMI 27 with no health conditions?
No — at BMI 27–29.9 one Tier 3 condition is required: prediabetes, prior heart attack, prior stroke, or symptomatic PAD. BMI alone qualifies only at 35+.
What if my BMI is 26.8?
The threshold is 27, and the measurement that counts is your provider's at prior authorization, not a home estimate. If you're that close, it's worth an accurate measurement at your next visit.
Related
Criteria source: CMS — Medicare GLP-1 Bridge · KFF