Kim Wohlwend, MSN, APRN, FNP-BC, PMHNP-BC
Dual ANCC board-certified Family and Psychiatric-Mental Health Nurse Practitioner. Eligibility logic based on published CMS Medicare GLP-1 Bridge guidance.
Last reviewed: May 13, 2026 | See full program details →
Quick Answer
You may qualify for the Medicare GLP-1 Bridge if you have Medicare Part D and meet one of three tiers: a BMI of 35 or higher; a BMI of 30 with heart failure, uncontrolled hypertension, or chronic kidney disease; or a BMI of 27 with prediabetes, prior heart attack, prior stroke, or peripheral artery disease. Qualifying patients pay $50 per month for Wegovy, Zepbound, or Foundayo between July 1, 2026 and December 31, 2027. The calculator below estimates your tier in about 60 seconds.
This calculator runs entirely in your web browser. Your height, weight, and condition selections are never transmitted to our practice, stored on a server, saved to your device, or shared with any third party. The result is calculated locally and disappears when you close the page. No name, email, or contact information is required to use this tool.
Self-Screening Calculator
Estimate your Medicare GLP-1 Bridge eligibility.
Answer five short sections. The result appears at the bottom of this page when you click the button. No name, email, or contact information is requested.
Your Result
Your eligibility result
Reminder: this is self-screening, not a clinical assessment. The Medicare GLP-1 Bridge prior authorization is reviewed by your Part D plan based on clinician-documented diagnoses, current BMI, and other plan-specific requirements. A "likely eligible" result here indicates the published CMS criteria appear to fit; it does not guarantee plan approval.
Where These Criteria Come From
The three Bridge eligibility tiers, in plain language.
CMS published three pathways to Bridge eligibility. The calculator above checks all three against your inputs.
Tier 1: BMI 35 or higher
No additional conditions required. The broadest Bridge tier.
Tier 2: BMI 30 or higher with one of three conditions
Heart failure with preserved ejection fraction, uncontrolled hypertension despite two antihypertensive medications, or chronic kidney disease stage 3a or above.
Tier 3: BMI 27 or higher with one of four conditions
Prediabetes per ADA criteria, previous heart attack, previous stroke, or symptomatic peripheral artery disease.
All three tiers also require Medicare Part D enrollment, combining the medication with structured nutrition and physical activity, and prior authorization through your Part D plan. None of the three Bridge medications (Wegovy, Zepbound, Foundayo) is appropriate for patients with the contraindications listed in section 5 of the calculator above.
For full program details, including pricing scenarios, the comparison of Wegovy vs Zepbound vs Foundayo, and what to do if you are already paying cash for a GLP-1, see our Medicare GLP-1 Bridge service page.
Sources
Where the eligibility logic comes from.
- Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge. cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge.
- CMS Press Release. Coming Soon: CMS to Provide $50 Monthly Access to GLP-1 Medications for Medicare Beneficiaries. 2026.
- U.S. Food and Drug Administration. Wegovy, Zepbound, and Foundayo Prescribing Information and Medication Guides. Current revisions.
- For a longer clinical overview, see our blog post Medicare GLP-1 Bridge Program: $50/Month Wegovy, Zepbound, and Foundayo Starting July 2026.
Frequently Asked Questions
Questions about the calculator.
Is this calculator HIPAA-compliant? Does my health information get sent to anyone?
No information is sent. The calculator runs entirely in your browser. Your height, weight, and condition selections are never transmitted to our practice, stored on a server, saved to your device, or shared with any third party. The result you see is calculated locally on your device and disappears when you close the page. No identifying information is collected unless you separately choose to join the waitlist afterward (which collects only first name and email).
How accurate is this calculator?
The calculator applies the published CMS eligibility criteria for the Medicare GLP-1 Bridge: BMI thresholds of 35, 30, or 27 paired with specific conditions per CMS guidance. The math itself is precise. However, this is a self-screening tool, not a clinical assessment. Final Bridge eligibility is determined by your Medicare Part D plan's prior authorization review, which requires clinician-documented diagnoses. A "likely eligible" result indicates the criteria appear to fit, not that approval is guaranteed.
What if the result says I qualify? What is the next step?
Join the waitlist to be notified when the Bridge launches on July 1, 2026, and we are ready to schedule eligibility visits. Or book an eligibility visit now so your prior authorization can be submitted on day one. The waitlist signup does not collect any health information from this calculator.
What if the result says I may not qualify?
You may still benefit from a clinical conversation. Some patients with BMI between 27 and 30 qualify under Tier 3 with conditions that were not on the calculator's pre-set list. Documentation matters too: a condition has to be in your medical record. We can review the full clinical picture at a visit. Alternative weight-loss paths, including non-GLP-1 medications and commercial-insurance options, may also be appropriate.
What if I have a contraindication?
Certain conditions make GLP-1 receptor agonists clinically inappropriate: personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), severe gastroparesis, active eating disorder, pregnancy, and planned pregnancy. These contraindications apply to Wegovy, Zepbound, and Foundayo across the board. If a contraindication applies, the Bridge is not the right path and we would discuss alternatives at a visit.
Calculator designed and reviewed by Kim Wohlwend, MSN, APRN, FNP-BC, PMHNP-BC. Dual ANCC board-certified Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner. Founder and lead clinician, Midwest Mind & Body Healthcare.
Last clinically reviewed: May 13, 2026. The eligibility logic will be updated as CMS issues additional guidance.
This calculator is for patient education and does not replace medical advice. Final Bridge eligibility is determined by your Medicare Part D plan's prior authorization review. This tool intentionally collects no name, email, or contact information, runs entirely in your browser, and transmits no data to any server.