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Medicare GLP-1 coverage in Georgia

As of July 1, 2026, Medicare covers GLP-1 medications such as Wegovy and Zepbound for weight management through the Medicare GLP-1 Bridge for eligible Part D enrollees, at $50 per monthly fill through December 31, 2027. knownwell is in-network with Medicare, offering both in-person care in Sandy Springs and telehealth services across Georgia.

Last updated:

November 3, 2026

Medically reviewed by: Angela Fitch, MD, FACP, FOMA, Dipl. ABOM

Comprehensive, empathetic weight management for Medicare patients in Georgia

In-person care at the Sandy Springs clinic or virtual care

Dedicated prior authorization team with expertise in navigating approvals under Part D and Medicare Bridge

Book a visit IN GEORGIA

Weight management for Medicare patients in Georgia

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Weight management & GLP-1 support

Our clinicians work with you toward your health goals and prescribe obesity management medications, like GLP-1s, when clinically appropriate — as one part of a broader care plan, never the whole plan.

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Nutrition counseling & health coaching

Our registered dietitians and health coaches partner with you at every visit, with care built around your goals, not a number on a scale.

In-person & virtual availability

We see patients in person at our Sandy Springs clinic which is close to Buckhead, Dunwoody, Brookhaven, Roswell, Marietta, Decatur, and virtually anywhere in Georgia.

$8 average copay per visit for Medicare patients in Georgia.

Medicare patients who haven't met their deductible may see higher costs early in the year. GLP-1s covered under the Medicare GLP-1 Bridge Program cost $50 per month, regardless of deductible phase.   

We accept Original Medicare, with or without most supplement plans and select Medicare Advantage plans.

Check what plans are in-network

Finding our Sandy Springs clinic

We're located in Sandy Springs, known as "Pill Hill," conveniently near Northside Hospital, Emory Saint Joseph's Hospital, and Perimeter Mall. Our clinic sits just a short walk from the Medical Center MARTA station.

Address: 1100 Lake Hearn Dr. NE Suite 160 Atlanta, GA 30342

Get directions

Fax:

(833) 464-5350

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Medicare GLP-1 Pathways

How does Medicare cover GLP-1s?

Medicare covers GLP-1s through your Part D plan for certain conditions, and through the Bridge for weight management.Medicare Part D: ‍

Coverable condition including: type 2 diabetes, cardiovascular risk, sleep apnea, metabolic dysfunction-associated steatohepatitis (MASH, or fatty liver disease)
Plan-specific: deductible, then tier cost sharing

‍Medicare Bridge Program: ‍

Weight management; BMI criteria met
$50 per fill, through Dec 31, 2027

Medicare Part D coverage for GLP-1s

Conditions Part D can cover

Type 2 diabetes (Ozempic, Mounjaro, others)
Cardiovascular risk reduction (Wegovy)
Moderate to severe obstructive sleep apnea (Zepbound)
Noncirrhotic MASH (Wegovy)

Who qualifies for Medicare GLP-1 coverage?

To be eligible under the Medicare GLP-1 Bridge program, you must be enrolled in Medicare part D and meet at least one of the following BMI-based criteria. If you have questions about your specific coverage options you should contact 1-800-MEDICARE (1-800-633-4227) or your local State Health Insurance Assistance Program. Your knownwell clinician can also help assess your options at your visit. Book a visit with a knownwell clinician.

BMI ≥ 35

Qualifies on its own,
no additional diagnosis required

BMI ≥ 30

Plus one of:

Heart failure with preserved ejection fraction (HFpEF)
Uncontrolled hypertension
Chronic kidney disease, stage 3a+

BMI ≥ 27

Plus one of:

Pre-diabetes
Prior myocardial infarction (MI)
Prior stroke
Symptomatic peripheral artery disease

Important exception to the Medicare Bridge Program

If you have a coverable condition under Part D, the Medicare GLP-1 Bridge programmay not apply.

For example, if you currently have an approved prior authorization through Part D for Zepbound prescribed for moderate to severe sleep apnea, Wegovy for cardiovascular risk reduction or noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH), or all FDA-approved medications for treating Type 2 Diabetes (Ozempic, Mounjaro, etc.), the Medicare GLP-1 Bridge program will not cover your medication.

For these indications, drug coverage will continue under your standard Part D plan’s formulary.

Medicare GLP-1 Bridge Program vs. Medicare Part D

If you have Medicare and are prescribed a GLP-1 medication, your cost and coverage will depend on which pathway applies to you — the Medicare GLP-1 Bridge or your Part D plan.

	Medicare GLP-1 Bridge	Medicare Part D (plan-specific)
Who qualifies	Medicare beneficiaries whose GLP-1 indication is not coverable under the basic Part D benefit (e.g., weight loss only)	Medicare beneficiaries whose GLP-1 indication is coverable under Part D (e.g., Wegovy for CV risk reduction, Zepbound for sleep apnea)
Patient copay / cost	$50 copay per fill — same regardless of which Part D benefit phase the patient is in	Plan-specific. Deductible may apply (up to $615 in 2026), then tier-based cost sharing
Counts toward out-of-pocket max?	✗ No — $50 copay does not count toward true out-of-pocket costs (TrOOP) or the gross covered prescription drug costs (GCPDC) under Part D	✓ Yes — counts toward out-of-pocket max ($2,100 in 2026)
Low-income subsidy (LIS / Extra Help)	✗ Does not apply — LIS subsidies do not reduce the $50 copay	✓ Applies — LIS beneficiaries may have reduced cost
Monthly cost predictability	Fixed $50 every fill, no phase changes	Variable Some plans offer Medicare Prescription Payment Plan (MPPP)
Prior authorization	Required under both programs — knownwell will help patients submit the PA regardless of pathway
How to confirm cost	Contact your preferred pharmacy	Call the specific Part D plan directly, or contact your state's State Health Insurance Assistance Program (SHIP) for guidance

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