health
Seniors in Medicare are about to get landmark obesity drug coverage
Many seniors may be unaware of the landmark coverage shift starting on July 1, with limited advertising seen from the government or Eli Lilly and Novo.
TL;DR
- Eligible Medicare beneficiaries gain access to obesity drugs through the new Bridge demonstration program starting July 1.
- The monthly copay for these drugs will be $50.
- A survey found that 82% of older Americans are unaware of this new coverage.
- Limited public advertising by CMS, Novo Nordisk, and Eli Lilly is noted as a reason for low awareness.
- CMS plans more promotions after the launch to be good stewards of taxpayer dollars.
- Providers and pharmacies are being prepared for the rollout, with some experts believing awareness will spread through them.
- Unlike traditional Medicare drug coverage, enrollment in the Bridge program is not automatic and requires eligibility, a prescription, and prior authorization.
- Novo and Lilly have historically invested heavily in advertising for their obesity and diabetes medicines.
- Beneficiaries must be enrolled in Medicare Part D to qualify, but the Bridge program is administered directly by CMS.
- Eligibility excludes those already covered for GLP-1s by their Part D plan for conditions like Type 2 diabetes.