Medicare will soon cover obesity drugs, but many seniors may not know

Millions of older Americans on Medicare are about to gain access to obesity medications for the first time; but this landmark change may be overlooked for many.

Starting Wednesday, eligible beneficiaries will be able to receive obesity medications Medicare’s new Bridge demonstration program for a co-monthly payment of just $50. The news marks a long-sought victory for patients, doctors and obesity advocates who have been pushing for broader access to blockbuster treatments. Novo Nordisk And Eli Lillyremained out of reach of many Americans.

But according to one survey, 82 percent of older Americans (including 79 percent of Republicans and 84 percent of Democrats) say they were unaware that Medicare would begin covering obesity medications. Published at the beginning of June By the Obesity Care Advocacy Network. The survey, conducted in late March among more than 2,100 adults aged 65 and over, was completed weeks before the government announced the survey. Bridge will expand its program Until 2027.

This data may not come as a surprise: While the government has provided strong support for health care providers and pharmacists, some doctors and other experts told CNBC they have noticed limited public advertising of new coverage from the Centers for Medicare & Medicaid Services or Novo and Lilly.

There may be good reasons for this. CMS did limited public promotion of the program ahead of July 1 because beneficiaries “tend to take the most action” when they are actually provided a benefit, an agency official told reporters on Thursday. They added that CMS will run more promotions after the launch “to be good stewards of our taxpayers’ money.”

Other experts also told CNBC that it may be necessary to make sure providers and pharmacies are prepared and resources are available before resorting to broad public support.

Still, some experts say a lack of awareness could delay some eligible adults from taking advantage of the new insurance coverage and starting treatments right away.

Tulane Obesity and Weight Loss Center medical director Dr. “I haven’t seen a lot of public information, and I think there will be a lot of people who have zero knowledge about the Bridge program,” Shauna Levy said. “And I think it’s going to take even longer for patients to find out and then see if they’re a good fit.”

Unlike traditional Medicare drug coverage, enrollment in the Bridge program is not automatic. Patients must meet eligibility requirements, obtain a prescription, and obtain preauthorization approval through CMS before coverage begins.

According to news by Zepbound and Mounjaro based on Reuters, Novo spent approximately $500 million on US advertising for its obesity drug Wegovy and its diabetes counterpart Ozempic in the first 9 months of 2025; That’s more than double the just over $200 million Lilly spent promoting its rival injections. data from ad tracking firm MediaRadar.

“I’m a little surprised Lilly and Novo aren’t advertising more to seniors to be ready to pick up their prescriptions,” said Leerink Partners analyst David Risinger, adding that getting an appointment with a provider takes time.

Medicare beneficiaries must be enrolled in Part D, a prescription drug plan, to qualify for the new coverage. But because the Bridge program is administered directly by CMS rather than Part D plans, private insurers do not need to play a role in educating beneficiaries about the new coverage.

“There is none of the marketing advantage of running through Part D plans,” said Kenneth Thorpe, a professor of health policy at Emory University.

He said “spreading the word” about the program and who is eligible will likely be among the biggest challenges of the rollout.

The program’s eligibility is broad, but some patients will not be eligible. This includes those with GLP-1 coverage from Part D plans for a use already covered by Medicare, such as Type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea.

While advertising for GLP-1 coverage did not reflect previous presentations, there was some promotion ahead of the launch.

Jamey Millar, the company’s vice president of U.S. operations, said in an interview Wednesday that targeted mentions on social media and Novo’s website advertised the Bridge program.

He acknowledged that no linear TV ads promoted the new coverage, but said he believed awareness among patients would come from providers and pharmacies. According to some physicians, CMS has provided extensive support to both about the upcoming program.

Millar likened the dynamic to an annual flu shot or shingles vaccine for older adults.

“Seniors who walk into a retail pharmacy after July 1 are on average taking eight medications, mostly oral, so the pharmacist has the opportunity to say: Did you know about Bridge?” he told CNBC. “So they’re equipped to do that and then [health-care providers] additionally.”

Limited public support ahead of July 1 may be by design. A slower rollout could give doctors, pharmacies and CMS time to prepare before potentially large numbers of beneficiaries begin seeking treatment.

“We generally take the view that before we can create broad awareness for consumers, similar to what we did at Foundayo, we need to make sure doctors are prepared,” Ilya Yuffa, president of Lilly USA and global client capabilities, said in an interview Wednesday. he said.

Yuffa was referring to Lilly’s recently launched obesity pill, Foundayo. Raising awareness among providers and the broader healthcare system primarily helps prevent “friction” between patients and doctors, he said.

Still, Yuffa said consumers should expect to see broader marketing efforts from Lilly around the availability of Foundayo and some sort of Zepbound through the Bridge program.

Some experts have suggested that CMS may also be trying to ensure the program meets an influx of interest. Beneficiaries must obtain prior authorization before receiving coverage, and processing these claims could become a significant undertaking if demand increases immediately after launch.

Director of the NYU Langone Medical Weight Management Program, Dr. “It may be so, let’s take the first month and see what mistakes we made so we can fix it instead of everything crashing and burning in a month or two,” Holly Lofton said.

“The thing is, there is access and hopefully the world will get better,” he said.