Medicare Update: Millions Eligible To Save Over $1,000 With Major Change
Summary
Medicare will start an 18-month pilot program allowing seniors with Medicare Part D to pay $50 a month for certain weight-loss drugs called GLP-1 medications. This program, announced by President Donald Trump and CMS, aims to make these drugs more affordable and gather information on their use and costs to decide on future coverage.Key Facts
- The pilot program begins July 1 and lasts 18 months, ending next year.
- It lowers out-of-pocket costs for GLP-1 weight-loss drugs, like Wegovy, from about $1,000 to $50 per month.
- Medicare previously did not broadly cover these drugs when prescribed only for obesity.
- The program applies to Medicare Part D beneficiaries who get prior approval from their doctor.
- Participants usually must have a body mass index (BMI) of 27 or higher, or lower with related health conditions.
- GLP-1 drugs have been linked to weight loss and may reduce obesity-related diseases.
- The program will help CMS decide if these drugs should be permanently covered by Medicare by 2028.
- Experts caution that long-term effects and economic impact of wider drug use are still uncertain.
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