PepsiCo, Starbucks and Cigna Cut GLP-1 Benefits as Medicare Rules and a $50 Bridge Program Shape Coverage Choices

PepsiCo, Starbucks and Cigna have trimmed employee coverage for weight-loss drugs, and the Medicare alternative is not a straightforward replacement. Eligibility depends on the diagnosis, with some patients able to get full Part D coverage and others limited to a temporary $50-a-month option.

PepsiCo, Starbucks and Cigna have trimmed employee coverage for weight-loss drugs, and the Medicare alternative is not a straightforward replacement. Eligibility depends on the diagnosis, with some patients able to get full Part D coverage and others limited to a temporary $50-a-month option.

PepsiCo said prescription weight-loss medicines had become one of the fastest-growing costs in its plans, and it kept coverage only for diabetes treatment. Cigna ended GLP-1 coverage for weight loss in its employee plan on July 1. Starbucks stopped coverage for eligible employees in October.

For a 65-year-old who lost employer coverage for Zepbound and is comparing Medicare drug plans during open enrollment, diagnosis now matters as much as the prescription itself. Medicare may cover the drug under Part D for certain medical conditions, while patients using it for weight management may have access to a separate $50 monthly option.

Diagnosis Can Decide Whether Medicare Will Pay

A federal law passed in 2003 prevents Part D from paying for drugs used only for weight loss. However, Part D can cover GLP-1 medications when they are prescribed for other approved medical uses. Wegovy may be covered to reduce cardiovascular risk in adults with established heart disease who are overweight or obese. Zepbound may be covered for moderate-to-severe obstructive sleep apnea in adults with obesity. Even so, coverage depends on the plan, and a prescription solely for weight loss is generally not paid for through standard Part D.

Plan rules still apply. Each insurer sets its own formulary tier and may require prior authorization to verify the diagnosis. These claims count toward the Part D out-of-pocket threshold, which rises to $2,400 in 2027 from $2,100 in 2026. The maximum deductible increases to $700 from $615. After a beneficiary reaches the threshold, covered Part D drugs cost nothing for the rest of the year.

A Temporary $50 Option for Weight Loss Runs Through 2027

The Centers for Medicare & Medicaid Services introduced the Medicare GLP-1 Bridge in July 2026 and later extended it through December 2027 after postponing its longer-term BALANCE program. The bridge charges a flat $50 per prescription, or $600 a year, for Wegovy, Foundayo, or the Zepbound KwikPen. Zepbound vials and single-dose pens are not included.

To qualify, a person generally needs Part D coverage, must meet one of the following medical criteria at the start of treatment, and cannot already qualify for regular Part D coverage of a GLP-1:

• BMI of 35 or higher, with no other condition
• BMI of 30 or higher plus heart failure with preserved ejection fraction, uncontrolled hypertension or stage 3a or worse kidney disease
• BMI of 27 or higher plus prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease

People with type 2 diabetes, moderate-to-severe sleep apnea or certain forms of advanced fatty liver disease are excluded from the bridge, even if their Part D plan does not cover the prescribed GLP-1. Those conditions may qualify for coverage through regular Part D instead.

Bridge Payments Do Not Count Toward the Part D Cap

Bridge copays do not count toward the Part D deductible or the annual out-of-pocket cap, and Extra Help cannot pay them.

The bridge offers predictable costs of $50 a month, or $600 a year. Regular Part D works differently: what you pay depends on the drug, the plan and other prescriptions, with covered out-of-pocket spending capped at $2,400 in 2027. Because the programs serve different groups, the $600 and $2,400 amounts are not direct competing prices for the same patient. Once someone reaches the Part D spending cap, covered prescriptions cost nothing for the rest of the year. Bridge copays remain separate and do not count toward that limit.

Higher earners also owe a Part D income surcharge on top of the plan premium. In 2026, it starts at $14.50 a month for individual filers with income above $109,000, and only about 8% of Part D enrollees pay it. That IRMAA surcharge is one of several income-based premium add-ons tied to earnings from two years earlier, which are often easy to miss.

The bridge also has an expiration date. Coverage after December 31, 2027 is not guaranteed, and many people regain weight after they stop taking these drugs. Without coverage, the medications can cost more than $1,000 a month out of pocket.

Three Things to Review Before Enrollment Ends

1. Match the prescription to your medical record. If you have moderate-to-severe sleep apnea or established cardiovascular disease, ask your doctor whether Zepbound or Wegovy is approved for your condition. Confirm that your Part D plan covers the medication and whether prior authorization is required.
2. Compare 2027 formularies before your plan renews. For each plan you are considering, check the Wegovy and Zepbound tier placement and prior authorization rules. Plans update formularies every year, and your choice takes effect on January 1, 2027.
3. Check bridge eligibility. Make sure your medication and formulation qualify, and ask your prescriber about prior authorization. Keep in mind that the temporary program ends on December 31, 2027, so coverage beyond that date remains uncertain.