BMI 35: you likely qualify outright
Short answer: A BMI of 35 or higher meets the Medicare GLP-1 Bridge's Tier 1 criterion by itself — no additional health conditions required. With Medicare drug coverage and a provider-submitted prior authorization, you can fill Wegovy, Zepbound (KwikPen), or Foundayo for a flat $50 a month.
Program facts last verified against CMS: July 21, 2026
What BMI 35 looks like, and what happens next
BMI 35 is roughly 216 lbs at 5'6", 230 lbs at 5'8", 242 lbs at 5'10", or 258 lbs at 6'0". At or above these weights, the eligibility conversation is short: confirm you have Medicare drug coverage, confirm you don't have a routing condition (type 2 diabetes, moderate-to-severe sleep apnea, or MASH — each of which moves you to standard Part D coverage instead), and have your provider submit the prior authorization to the program's central processor.
Time matters more than most people realize: the program ends December 31, 2027, with no announced successor. Starting the provider conversation now means starting therapy with the maximum possible runway at the $50 rate.
Quick BMI check
Take the full 2-minute eligibility check →
Common questions
Is there any BMI too high for the program?
No upper limit appears in the criteria — 35 and above qualifies under Tier 1.
Do I get to choose which drug?
That's a clinical decision with your prescriber among the three covered products: Wegovy, Zepbound (KwikPen form only), and Foundayo.
Related
Criteria source: CMS — Medicare GLP-1 Bridge · KFF