Medicare Obesity Coverage 2026: How to Get $50 GLP-1 Copays via TrumpRx

A Historic Policy Reversal For decades, Medicare was barred by law from covering weight loss. That ended in 2026 with the GENEROUS Model pilot program. Through this CMMI demonstration, Medicare Part D now covers Wegovy and Zepbound for patients with a BMI over 30 (or over 27 with one weight-related condition like hypertension).

The "Phase-In" Schedule The $50 copay isn't open to everyone on day one. It is rolling out in three phases:

1. Phase 1 (Current): BMI >27 with pre-diabetes or cardiovascular disease.
2. Phase 2: BMI >30 with hypertension or kidney disease.
3. Phase 3: All beneficiaries with BMI >35.

Medicaid "Opt-In" Status Unlike Medicare, state Medicaid programs must "opt-in" to the TrumpRx pricing agreement. States that participate can access a "Most-Favored-Nation" wholesale price of $245, allowing them to offer these drugs to low-income residents for nearly $0 copays. Check your state's "Letter of Intent" status on TrumpRx.gov.