Beginning July 1, 2026, eligible federal health insurance beneficiaries may access approved GLP-1 weight loss prescriptions for a predictable $50 monthly copay at pharmacies.
Eligibility requires enrollment in a prescription drug plan, plus BMI 27 with certain listed health conditions, or BMI 35 regardless of conditions.
The pilot uses prior authorization through a central federal system, not regular drug plan processing; approved patients pay the flat copay at pickup.
Compared with discounted cash prices of $149 to $699 monthly, $50 is lower; however, it excludes deductible and $2.1K out-of-pocket cap credit.
After Dec. 31, 2027, a longer-term option remains uncertain; the extension gives insurers more usage data and negotiation time before potential 2028 decisions.
