Medicare Updates:

The Annual Enrollment Period (AEP) runs from October 15 to December 7 each year, giving Medicare beneficiaries a chance to review and change their coverage for the following calendar year; changes take effect January 1. During this window, beneficiaries can switch from Original Medicare to a Medicare Advantage plan or vice versa, move from one Medicare Advantage plan to another, and join, switch, or drop a standalone Medicare Part D prescription drug plan.

You cannot enroll in Medicare for the first time during AEP. Also, if you convert from Original Medicare to Medicare Advantage, you lose guaranteed issue rights to buy or switch Medigap (Medicare Supplement) plans — insurers can then medically underwrite those policies outside specific windows, raising prices or denying coverage. Missing this AEP window generally means waiting until the next one. Please consider making an appointment to meet with me during this year’s AEP if you have questions about your coverage options.

The Medicare GLP-1 Bridge Program is a temporary CMS program running from July 1, 2026 through December 31, 2027, created to test whether providing access to GLP-1 weight loss medications at a uniform CMS-negotiated price improves beneficiary outcomes and reduces long term Medicare spending. The program serves as a bridge to eventually including these medications as part of Part D prescription drug coverage itself.

The drugs covered under the program are Wegovy (both injectable and tablet forms) and Zepbound, plus Foundayo, and qualifying beneficiaries must be at least 18 with a Body Mass Index (BMI) ≥35 or have other chronic health conditions (e. g. pre-diabetes, etc.). If someone already qualifies for a GLP-1 drug through their Part D plan for something other than weight loss, they would not be eligible for this new bridge program.

The program's $50 copay works differently from regular Part D cost-sharing: the total negotiated price for covered GLP-1 drugs under the Bridge is $245 per month, of which beneficiaries pay a flat $50 copay — and this copay does not count toward Part D out-of-pocket costs or subsidies, making it a separate track entirely from the deductible and out-of-pocket maximum.

Enrollment in the program requires getting a prescription from your provider, then having the pharmacy run the claim through the Bridge's billing system, and then having the prescribing provider submit a prior authorization form; approval or denial is then mailed to both the member and doctor, typically within 72 hours. 

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