A prior heart attack and the Medicare GLP-1 Bridge
Short answer: A previous heart attack is a Tier 3 qualifying condition: with a BMI of 27 or higher, it makes you eligible for Medicare's $50/month GLP-1 Bridge program. The criteria set no time limit — a heart attack from decades ago counts, as long as it's documented in your medical record.
Program facts last verified against CMS: July 21, 2026
Why heart-attack history qualifies at the lowest BMI tier
GLP-1 medications have demonstrated meaningful reductions in repeat cardiovascular events for people with established heart disease — Wegovy carries an FDA-approved cardiovascular risk-reduction indication on exactly that evidence. CMS accordingly placed prior heart attack in the tier with the lowest BMI threshold: 27, which is about 167 pounds at 5'6".
Documentation is usually easy
A heart attack (myocardial infarction) is among the best-documented events in any medical record — hospital records, cardiology notes, or stent history all establish it. Mention it to whichever provider handles your prior authorization, especially if it happened long ago or in another state, so they can confirm it's reflected in your current chart.
If your cardiac history is angina, stents, or bypass surgery without a confirmed heart attack, eligibility under this criterion depends on what your record shows — ask your cardiologist. Symptomatic peripheral artery disease, a separate Tier 3 condition, sometimes applies to the same patients.
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Common questions
My heart attack was in 1998. Does it still count?
Yes — the criteria set no time window. It needs to be documented in your medical record, which your provider confirms during prior authorization.
Do stents or bypass surgery without a heart attack qualify?
Not automatically under this criterion — it's specifically a prior heart attack. But your chart may document one you weren't told about in those terms ('silent MI'), so it's worth asking your cardiologist directly.
Is it safe to take a GLP-1 after a heart attack?
For many patients the evidence is favorable — GLP-1s reduce repeat cardiovascular events in people with heart disease — but your cardiologist makes the individual call as part of the prior authorization.
Related
Criteria source: CMS — Medicare GLP-1 Bridge · KFF