Does the Bridge work with any Medicare plan?

It works with eligible Medicare Advantage (MA-PD) or standalone Part D plans. Humana processes Bridge claims nationally; you do not need a Humana plan.

Does the $50 Bridge copay count toward TrOOP?

No. The Bridge is a separate CMS pilot outside the Part D benefit, so the $50 copay does not count toward True Out-of-Pocket.

What pharmacy billing codes does the Bridge use?

Pharmacies bill Bridge claims using BIN 028918 and the program’s processor routing. Timing and prior authorization within 72 hours matter before dispense.

Medicare GLP-1 Bridge Program: What It Is and How It Works (2026)

A pharmacist-led guide to Medicare's GLP-1 Bridge pilot: who qualifies by BMI tier, how pharmacy billing works (BIN 028918), the 72-hour prior authorization workflow, and what the $50 copay does (and does not) count toward.

Who the Bridge is for

The Bridge program is designed for Medicare beneficiaries who meet BMI and clinical criteria for anti-obesity GLP-1 medications such as Wegovy or Zepbound. Eligibility tiers, pharmacy BIN 028918 billing, and the 72-hour prior authorization clock all matter before a pharmacy can dispense.

If you are comparing coverage options while on GLP-1 therapy, also review your Part D formulary, Medicare Advantage networks, and Medigap gaps so drug access and medical coverage stay aligned.

What to verify before you fill

BMI tier and documented comorbidities that support eligibility
Pharmacy can route Bridge claims to BIN 028918
Doctor office is ready for the 72-hour prior authorization window
You understand the $50 Bridge copay does not reduce Part D TrOOP

Local help in Alabama

Dalton Insurance Agency in Dadeville helps Alabama seniors coordinate drug coverage with the rest of their Medicare plan. Start with our Medicare in Alabama guide, Annual Enrollment Period checklist, or a Dadeville Medicare advisor visit.

Open the full GLP-1 Bridge prior authorization guide · Book a free consultation · Call (334) 489-3624 · Medicare blog · Free calculators