To be eligible, you need either a BMI of >=35, or a BMI of >=27 and a set of specific health conditions (uncontrolled hypertension, chronic kidney disease, pre-diabetes, etc). You also can't be qualified for GLP-1s under Medicare's previous Part D coverage.
In practice these criteria are narrower than they look. Of the 13 million Medicare beneficiaries with overweight or obesity, about 4 million actually qualify, because most are excluded for already having a diagnosis, like type 2 diabetes or sleep apnea, that covers a GLP-1 another way.
To be eligible, you need either a BMI of >=35, or a BMI of >=27 and a set of specific health conditions (uncontrolled hypertension, chronic kidney disease, pre-diabetes, etc). You also can't be qualified for GLP-1s under Medicare's previous Part D coverage.
In practice these criteria are narrower than they look. Of the 13 million Medicare beneficiaries with overweight or obesity, about 4 million actually qualify, because most are excluded for already having a diagnosis, like type 2 diabetes or sleep apnea, that covers a GLP-1 another way.