The short answer

The Medicare GLP-1 Bridge needs one main piece of paperwork: a prior authorization that your doctor submits — not you. There is an official CMS Bridge prior-authorization form, sent electronically (preferred) or by fax to the program's central processor — not to your own Part D plan. Your job is simple: show up to your appointment with the right information so your doctor can fill it out and submit it in one visit. Here is exactly what that takes, plus a checklist you can print and bring.

One timing note up front: prior authorizations cannot be submitted before July 1, 2026, when the Bridge opens. You can prepare now, but nothing is filed before then.

Who fills out the form (and where it goes)

This trips people up, so let us be clear:

  • Your provider submits the prior authorization and the prescription. You do not fill out a form yourself.
  • It uses the official Medicare GLP-1 Bridge prior-authorization form, submitted electronically or by fax (CMS encourages electronic).
  • It goes to CMS's single central processor for the Bridge (reported to be Humana) — not your individual Part D plan. That is different from a normal drug prior authorization, so even an experienced office may need to know this.

What the form has to show

Your doctor attests to two things on the form:

  1. That you are being treated to reduce excess body weight, and
  2. That you meet one of three BMI-and-health tiers:
    • BMI 35 or higher (on its own), or
    • BMI 30 or higher with heart failure, uncontrolled high blood pressure, or chronic kidney disease, or
    • BMI 27 or higher with prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease.

Not sure which tier you fall into? Our 2-minute eligibility quiz walks through it.

Your appointment checklist

Bring these so your doctor can complete and submit the form in a single visit:

  • Your Medicare card and Part D (or Medicare Advantage drug) plan information
  • Your current height and weight (so your BMI can be confirmed)
  • Records of your qualifying conditions — diagnoses or recent results for heart failure, chronic kidney disease, prediabetes (A1c), a prior heart attack or stroke, or peripheral artery disease
  • Your current medication list
  • The specific drug you want by name: Wegovy, the Zepbound KwikPen, or Foundayo (remember, Ozempic and Mounjaro are not in the Bridge — see which drugs the $50 Bridge covers)
  • Any past records of weight-related treatment, if you have them

Print this page, or jot the list on a card, and take it to your visit.

What to say to your doctor

Many people search this exact thing, so here is a simple script:

"I would like to be considered for the Medicare GLP-1 Bridge for weight management. Can you submit the prior authorization to the Bridge's central processor for [Wegovy / the Zepbound KwikPen / Foundayo]?"

If the office is not yet familiar with the Bridge, let them know CMS has a dedicated prescriber information page and prior-authorization form for it. If you still need a prescriber, our provider directory lists clinicians who accept Medicare.

After your doctor submits

  • The central processor reviews the request — approved, denied, or needing more information.
  • Once approved, you fill at a participating pharmacy for the flat $50 a month.
  • For the full process and what to expect at each step, see GLP-1 prior authorization on Medicare.
  • If it comes back denied, it is often a missing-documentation fix — talk to your doctor, and see your other options if you do not qualify.

A note on timing

The Bridge opens July 1, 2026, and CMS is finalizing the prior-authorization form and process details (expected June 2026). You cannot file before July 1 — but you can gather this paperwork and book an appointment now, so you are ready on day one.

Data note

Data as of June 2026. CMS is still finalizing the Bridge prior-authorization form and submission details. Always confirm the current form and requirements with your doctor, your plan, or at Medicare.gov. This is educational, not medical advice.