Episode 253: One Month Into the Medicare GLP-1 Bridge: What You Need to Know

[00:00:00] Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get on track and stay on track with your weight loss journey. I'm your host, Dr. Alicia Shelly. So let's get started.

[00:00:27] Welcome back to the Back on Track Achieving Healthy Weight Loss podcast. I'm your host, Dr. Alicia Shelly. It has now been maybe over a month since the Medicare GLP-1 Bridge program launched. And I wanted to come back and talk about what I've learned actually helping patients navigate this program. Because when the Bridge program was first rolled out, there was a lot, a lot of information.

[00:00:54] I mean, patients were trying to figure out, physicians were trying to figure out, even pharmacies were trying to figure out. And when you first looked at all the requirements, seemed like it would be pretty simple and pretty easy. But you know what? There's a lot of nuances there that I want to share with you, especially if you're trying to get yourself or a loved one on this program. Now, anything that involves the government is going to be somewhat complex.

[00:01:20] I mean, there's always going to be rules, processes, and there are definitely a few places where things can get held up. But once you understand the pathway, it becomes much easier to navigate. So today I want to share with you some tips and tricks that I have learned during this first month of helping patients get approved for the Medicare GLP-1 Bridge.

[00:01:40] So we are going to be talking about what exactly the Bridge is, who qualifies, who doesn't qualify, which medications are included, and what your doctor needs to do, and what the pharmacy needs to do. And what can you do as a patient to help move the process along? And once you actually get the medications, what should you be doing to maximize your results? So let's start from the beginning.

[00:02:07] First, what is the Medicare GLP-1 Bridge Program? I still have patients where I walk in and say, hey, have you heard about this bridge program? And they're like, what? So there are people out here that did not know that this exists. And so for those that may be wondering exactly what is this, the Medicare GLP-1 Bridge Program is a temporary program through the Centers of Medicare and Medicaid Services, or CMS. It began July 1st, 2026, so last month.

[00:02:36] And it's currently scheduled to continue through December 31st, 2027. That's when it will end. And it's just for Medicare beneficiaries who meet their eligibility criteria and who has Part B insurance or Advantage plan. And the program provides access to certain GLP-1-based weight management medications for a $50 copay for a one month supply. But I want to make something clear.

[00:03:05] The bridge is not simply Medicare Part D suddenly decided to cover all medications. No, this is a complete separate pathway than Medicare Part D. They're not even processing this through your Medicare Part D. So the bridge operates outside the normal Medicare Part D. And for those who are wondering, what is Medicare Part D?

[00:03:28] So when it comes to seeing your doctor and going to the hospital, those are your Medicare A and B. And then Medicare Part D is your drug plan. So the plan that covers all your medications and things of that nature. And so usually medications would go through your Part D coverage. However, with the bridge, it's completely separate. It has its own payment process.

[00:03:54] And it's designed to really help certain Medicare beneficiaries access obesity medications when they meet specific clinical and insurance criteria. And it expands access from what the Part D is already covering. So before you call your doctor's office and say, I heard I can get my GLP-1 for $50. The first question you have to ask is, do I actually qualify? And this brings me to tip number one.

[00:04:22] Know your eligibility criteria. This is probably the most important thing you can do. Because not everybody with obesity and Medicare is going to qualify for the bridge program. There are specific clinical criteria and three main pathways on how to get approved. Now, pathway number one is if your BMI is 35 or greater. And if your BMI is 35 or greater, then you would actually qualify for the bridge program.

[00:04:50] Now, if your BMI has to be 35 or greater when you started a GLP-1 therapy. Because many people are paying out of pocket for this or using other modalities. And so they may have lost weight. So it needs to be when you first started the GLP-1 therapy. And once you can meet the clinical criteria without needing any additional conditions required for the lower BMI criteria. So the first pathway is simple. Just a BMI of 35 or greater.

[00:05:19] Pathway number two. If your BMI is of 30 or greater plus one qualifying condition. So if your BMI is 30 or greater, you need at least one of the following. Either heart failure with the preserved ejection fraction. Or also called HEF-PEF. Or uncontrolled hypertension. Or chronic kidney disease stage 3A or higher.

[00:05:44] And when we say uncontrolled hypertension, for the purposes of this program, there is a specific definition. It means your blood pressure is still above 140 over 90. Despite being on a minimum of two blood pressure medications. So simply having a diagnosis of hypertension does not necessarily mean that you meet this particular criteria. So, pathway number three.

[00:06:09] You need to have a BMI of 27 or greater plus one qualifying condition. So if your BMI was 27 or greater, you need at least one of the following. A history of prediabetes, previous heart attack, previous stroke, or symptomatic peripheral arterial disease. So, I want you to remember the three categories. Either BMI of 35 or greater by itself. BMI of 30 or greater plus one qualifying condition.

[00:06:37] Or BMI of 27 or greater plus one of the other qualifying conditions that I mentioned. And unfortunately, there are going to be people who fall in between the cracks. So, for example, you may have a BMI of 32 and have obesity. But if you do not have heart failure with preserved ejection fraction, qualifying uncontrolled hypertension, or stage 3A of chronic kidney disease, you may not meet the bridge criteria. And that is frustrating.

[00:07:06] But it's important to understand that before you spend your days calling your doctor's office and pharmacy thinking that somebody has done something wrong, it's important that you know what your criteria is and whether you are in those cracks. Because not everybody will be eligible for this program. Now, tip number two. Your current BMI may not be the BMI that matters. Now, this is a very important point. Especially for people who are already taking a GLP-1.

[00:07:34] Like I mentioned before, you may be already on one. You may be paying out of pocket. You may be getting compounded option. But then the bridge criteria looks at your BMI when you initiated a GLP-1 therapy or when you started a GLP-1 therapy. For some of my patients, I'm having to go back to 2022, 2021 when this started coming out because sometimes they were paying out of pocket. Or they had insurance, their regular commercial insurance that was covering it. And then when they switched to Medicare, they were no longer covered.

[00:08:03] So they're paying out of pocket. And so if you started the GLP-1 two years ago and your BMI was at that time 37, and you've done very well on your treatment and now your BMI is either 31, 32, congratulations. The lower BMI that you have does not necessarily mean that you don't qualify. It has to go based on that 37 that you had when you first started.

[00:08:26] So I realized it could be kind of difficult to remember exactly where you were when you first started, especially even for myself having to go back. And if the patient maybe was not my patient at the time, they may be seeing somebody else. But do your best. The good thing now we have electronic medical records that may help you to be able to go back and see what it was when you first started. And then also look to see what medications you had at that time.

[00:08:54] You may have had some prediabetes that is now resolved because you're on the GOP-1 therapy, but that would count as long as you have that history. So just don't assume that because your BMI is lower that you don't qualify. See, go back. You may be very surprised that you would qualify. All right. Tip number three. Know when you should be going through your Part D insurance instead.

[00:09:17] This next part can be very confusing and frustrating at the same time because there are certain medical conditions for which GOP-1 medications already have an FDA approved indication and that Medicare Part D will cover. These conditions include type 2 diabetes, moderate to severe obstructive sleep apnea, non-cirrotic, MASH, or fatty liver disease with moderate to advanced liver fibrosis or a stage F2 to F4.

[00:09:46] A history of a heart attack, history of a stroke, history of peripheral arterial disease can usually be covered under the Medicare Part D in certain GOP-1s. So there's certain GOP-1s that are FDA approved for these different conditions, so you would use that particular GOP-1. But if you have any one of these FDA indications, you may need to go through your regular Part D pathway rather than bridge. However, if you have the history of a heart attack, stroke, or peripheral arterial disease, you could still go through the bridge.

[00:10:15] And then this is the other caveat. As long as you don't have any already claims for GOP-1 using those indications. And I'll talk a little bit more about that and the subsequent tips, but I'll stop there. So you may say, but my Part D plan proved the medication, but my co-pay is $600 or $700. Why can't I not just use the bridge and pay $50?

[00:10:41] Unfortunately, the bridge was created as an option to simply choose the cheaper pathway when your medication is already being covered through the Part D for an FDA indication. To rephrase that, the bridge is not created as a cheaper pathway. So if your Part D actually covers this medication, then if they already covered the medication, then you have to go through your Part D. They won't allow you to use the bridge.

[00:11:06] And if you already have qualifying GOP-1 medication, but the cost is too high, usually that's due to the fact that you have to meet your deductible. And so each year, the Medicare beneficiaries have a deductible they have to meet. Especially January 1st is a big problem when all the medications are like $600, $700 until they need it. And then the price goes down. But Medicare does have a smoothing program where they will smooth out that deductible.

[00:11:34] So you pay it basically monthly throughout the year so you're not having to pay that $600 to $700, especially if that's really hard for your budget at that time. So when you sign up for next year, make sure that you ask them about that program if that would be a benefit to you. So once again, in conclusion, before assuming the bridge is automatically the best option, we have to understand why the medication is being prescribed, what was the medical condition, if any, and which Medicare pathway applies to you.

[00:12:03] Whether you have to go through Part D or you can go through the bridge. So tip number four, make sure you actually have Medicare Part D. The next eligibility requirement is insurance. You need to be eligible for Part D prescription drug coverage or have it. That can be a standalone Medicare Part D prescription plan, like a supplement plan, or that can be part of your Advantage plan. That includes Part D prescription coverage.

[00:12:30] This has already caused some confusion for some patients because they may have decided to opt out of Medicare Part D because they don't have that many medications they need. But then when it came to the bridge program, they're like, well, can I get this? And I was like, no, sorry, you don't have Part D. So it's important to know what you have. Just because you have UnitedHealthcare, Medicare, or Aetna Medicare, it doesn't necessarily mean you opted in to get that Part D coverage.

[00:12:55] So make sure your Medicare plan includes some type of Part D prescription supplement or coverage with your Advantage plan. And I do want to say a special word about TRICARE for Life because I've had a lot of patients where this has come up. They have an Advantage plan, but for their prescription, their D part, they're using TRICARE for Life to cover their prescriptions. But unfortunately, TRICARE for Life is a government program and it is not covered under Medicare Part D.

[00:13:25] So a few years back, TRICARE for Life was covering GOP-1s, but then they stopped covering it for that subset of people. And so, you know, it's frustrating. And I just want to say a moment about this is where advocacy is important because these medications are simply not just to help people with losing weight. They actually can affect serious obesity-related diseases. And we're talking about, you know, improving heart disease, improving sleep apnea, improving diabetes, kidney disease, fatty liver disease.

[00:13:55] These are medical conditions that can affect quality of life and your mortality. So if you are in a population that does not have access, like TRICARE for Life, I encourage you to advocate for yourself, call, send letters, contact the people who are making these decisions and let them hear from patients who are actually affected and why this medication is helpful. So tip number five, make sure your doctor prescribes the right medication and formulation. Let's say you meet the criteria.

[00:14:24] You have eligible Part D coverage. What's the next step? Well, first off, it's important to realize that the bridge doesn't cover all GOP-1s. It just covers your Wagovi injection, Wagovi pill, Fondeo pill, and ZetBound quick pen. And I need to stop on Zepbound for a moment because this is one of these little details that we learned very quickly. There are different ZetBound formulations.

[00:14:50] There's a regular single-dose injector pen that is used for commercial insurance. And then there are single-dose vials and ZetBound and quick pens that are used for self-pay. But for the bridge program, you only need the ZetBound quick pen. They do not cover the ZetBound files or the ZetBound injector pen. So your doctor can write a prescription for ZetBound and think, yes, I sent ZetBound.

[00:15:16] But if it's the wrong formulation that they selected, whether they selected the vial or the pen instead of the quick pen, the pharmacy will simply run it through your regular insurance or in regards to the vials, it'd be self-pay. Actually, I want to say with the vials, you can only get from Lily Direct. But anyway, they'll just run it as they'll run the pen through your insurance. So if you're requesting ZetBound through the bridge program, remember to write quick pen, quick pen, quick pen, and ask your doctor for them to cover the pen needles.

[00:15:46] Now, the pen needles will go through your regular insurance and they're not that expensive. I think one of the pharmacists was telling me that it may be a few dollars for the pen needles, but just make sure they order it, the pen needles through your insurance. So what should you put on the prescription? So the one thing that I've been doing in my own practice, just to make it easy for the pharmacies, I'll write the prescription and then I will include the patient's obesity diagnosis.

[00:16:11] So I write out the ICD-10 code, for example, which is E66-811 for class 1 obesity, E66-812 for class 2 obesity, and then E66-813 for class 3 obesity. So I'll write all that out so that they know what their class is. And then I actually will write their BMI and diagnosis in English. So I'll write their BMI is 35 or BMI of 40.

[00:16:39] And then I write the qualifying comorbidity, because if they have a BMI of 30 and prediabetes, they need to know that so that they can submit that information. So they have prediabetes, chronic kidney disease, heart failure with preserved ejection fraction, uncontrolled hypertension, a previous heart attack or stroke. So I make sure I add that to the prescription. And then also I say, send to Medicare GOP-1 bridge for weight management.

[00:17:05] So I write all of that out so that at least they know that this is going not to your Part D plan, but to the Medicare bridge program. And I do that because I want whoever to receive this prescription to understand where it's supposed to go. Sometimes because we're not communicating as well, the pharmacy is like, we'll just send it regularly. So it's important to do that, to put it out they know and they can be able to submit it. Because this is not a self-paid prescription and it's not going through the regular insurance.

[00:17:34] We're trying to process this through the Medicare bridge program. So tip number six, make sure your pharmacy has your red, white and blue Medicare card number. So your pharmacist also has to submit your Medicare beneficiary ID, which is on your red, white and blue Medicare card. And traditionally, the pharmacy doesn't really ask for your Medicare card because that's supposed to cover your A and B.

[00:18:00] And so that Medicare A and B, that is that what's on that number on the red, white and blue. So that's usually at your doctor's office. So the other thing we've been trying to do is if we have somebody that just has Medicare alone, plus a supplement, I'll include that Medicare identifier number as well just to help them out. Because then the person who is processing it can process the prescription faster instead of having to wait, call the office, wait on hold to talk to the nurse to ask them what their beneficiary ID is,

[00:18:29] or ask you for your last four digits of your Social Security number so that they can actually look it out. So it makes the process run a little bit faster. So take that card with you when you go to the pharmacy so they may be able to have that and kind of move the process along. So tip number seven, stay engaged with your pharmacy. This is one of the biggest tips after working with the program over the last month. Communicate, communicate, communicate.

[00:18:57] Do not assume that because your doctor sent the prescription, everything is automatically moving behind the seats. Because sometimes it's not. Sometimes it is stopped out of hold because pharmacies are busy. They're filling hundreds, even thousands of prescriptions per day. And when there's something different about a prescription, resolving it may require them to stop what they're doing, call the doctor's office, be on hold, speak to the nurse. You know, they may get the additional information. They have to go back to process the prescription again. And that takes time.

[00:19:27] And imagine if you're spending 10 minutes each time, you're never going to be done. And so what happens is the prescription will sit and it delays it from getting onto that next process, that next stop. It doesn't mean that anybody's refusing to help you. It just means there's probably not enough hours in the day for them to go through all the prescriptions and trying to get it filled, get it sorted. When they have thousands more, they have to do that day. So it is important that you stay engaged, call the pharmacy, go up there and ask,

[00:19:55] Hey, where are we in the bridge process? You know, did the doctor submit the prescription? Is there anything that you need from the doctor's office? Did it generate a prior authorization? If the pharmacy tells you, oh, we need this information from your doctor's office, then you call your doctor's office and tell them exactly what the pharmacy needs. Because, you know, you shouldn't have to coordinate everything. But practically speaking, sometimes staying involved gets the ball rolling much faster.

[00:20:21] Because what if the doctor didn't get the communication that something was wrong with your prescription and it's just sitting there in limbo? Because I always like to say the squeaky wheel gets the oil, you know, being respectful, but just, you know, checking in. And I wouldn't check in like daily. I would check in, you know, after a week or so saying, hey, I just wanted to ask where we are in that status. Tip number eight, what actually happens at the pharmacy?

[00:20:45] So once the pharmacy has the prescription and your Medicare information, they process the prescription through the Medicare GOP-1 bridge central processor. The bridge has its own electronic processing pathway. And the system then evaluates whether there are issues that make you more ineligible, you know, that you couldn't join the program because maybe you had a claim that was already placed for GOP-1.

[00:21:10] Or maybe, you know, you have a particular condition that it would be better for you to go through your Part D. And then based on that system, it will give a code to the pharmacy. And so for the doctor's office to actually proceed and complete the prior authorization. One of the things that matters is whether you're already receiving a qualifying GOP-1 through Part D, like I mentioned. During that review period, the pharmacy will check for any previous claims through your Part D.

[00:21:37] If the system identifies that you've already received that medication, you will be denied and be sent back to use your Part D coverage instead. And so it's important to understand that there is a difference between the bridge program and your regular Part D claim. They're not the same pathway. And sometimes we have to go back and forth for patients so that they understand. So tip number two, tip number nine, the pharmacy claim has to happen before the doctor fills out the prior authorization.

[00:22:05] This is one of these little nuances that can create a lot of confusion. Now, the process goes like this. First, your doctor sends a prescription to the pharmacy. Second, the pharmacy submits the claim to the Medicare GOP-1 bridge central processor. That claim either establishes you in the bridge system to see if you meet eligibility. If the answer is yes, you do meet, then the prior authorization is sent to your doctor's office.

[00:22:30] If your doctor tries to complete the bridge prior authorization before the pharmacy has established that the claim in the system, it can create problems. In fact, it'll just be a denied. So you have to remember the sequence. Prescription, pharmacy bridge claim, prior authorization. And you do not necessarily have to go through your regular Part D plan to obtain a denial first. The pharmacy can process the prescription through the bridge pathway directly. So what happens after the prior authorization comes to the doctor?

[00:23:00] Once the pharmacy processes the bridge claim, the doctor will receive a prior authorization request. Most offices use electronic system to complete their prior authorizations. The one we like to use is cover my meds. Depending on the pharmacy and the electronic system being used, the prior authorization request may come electronically or you can just transmit it manually and fax it back. So it just depends on how your doctors like to move.

[00:23:26] Once we get it, the actual claim form is very straightforward. Because we already know that your eligibility criteria, we've documented in your progress note, your BMI, your condition. We have your Medicare information, clinical history. So we basically just submit that information back. And then once everything's submitted correctly, you get approval right away. So it is actually very quick once we get the prior authorization.

[00:23:54] So it is important that we get it so that we can be able to process it. Now, tip number 10, follow up if you haven't heard anything. So just like I mentioned before, it is important to advocate for yourself. If you haven't heard anything, it's been over a week, don't assume that everybody else knows exactly where the process is. Sometimes the pharmacy is waiting up for the doctor's office. Sometimes the doctor's office is waiting for the pharmacy. Sometimes the prior authorization request never came through.

[00:24:21] There are so many times electronically I will send a prescription and the pharmacist does not get it. I don't know what happened. I don't know where it went in the electronic world, but they didn't get it. So we're all waiting on each other. We're just sitting here in limbo. And then what if the medication was written wrong? You know, the formulation is not right. Or maybe the prescription was processed through your regular insurance and not the bridge program.

[00:24:46] So all of these little nuances that can cause that prescription to wait and you not to hear anything. So it is important that after a week or so, you should call and just give a status. Hey, where are we? Ask the pharmacy. Have you heard from the doctor's office or have you gotten that prescription? Call the doctor's office. You know, can you give me a status update?

[00:25:08] Sometimes one phone call identifies exactly where the process stopped because then they can look and say, oh, we never received this prescription. Or, oh, let's see. It looks like, okay, now here we go. We just needed to send this to the central processor and now we'll send everything to your doctor to fill out. So sometimes just asking and being polite, please, please, please, please be polite. It does make a difference. You know, one call can just be so helpful in moving this process along.

[00:25:37] And I do want to say, please give your physicians, your clinicians, pharmacies a little grace. This is a new program. And so the one thing I would say is that, you know, especially being a former primary care doc, it's a busy time. There's so much that you're doing on a daily basis. So you may not be aware that ball has dropped. And so, you know, just be courteous as you're talking to staff. That makes a huge difference, too. With the pharmacies, you know, they're dealing with so much, an enormous workload on a daily basis.

[00:26:06] So, you know, by just being cordial, being friendly, you know, and still being able to ask where the status is will actually serve you in the long run. So now you're approved. Let's say everything works out. You meet the criteria. You have the eligible Part D coverage. The correct medication was prescribed. And the pharmacy submitted the bridge claim. And doctors has completed the prior authorization. And now you are approved.

[00:26:34] The good news is that once the Medicare GOP-1 bridge prior authorization is approved, that approval can remain valid through December 31st, 2027. So we don't have to do this again. However, you're not in starting the entire process over every single month. And now if you do want to switch to a different bridge covered GOP-1 medication, there may be another prior authorization that's needed. So once you made it through this process, refill should be easier. You should be approved.

[00:27:03] You not have to worry about it. You should only have to pay $50. Now that you have the medication, what else should you be doing? And this is where I want to shift the conversation because sometimes you spend so much energy trying to get the medication that we forget what we need to do once we actually have it. Because medication does not work in a silo. Obesity treatment works best when we combine medications with comprehensive lifestyle intervention. So once you get your medication, I want you to pay attention to several things.

[00:27:33] First thing is protein. Make sure you're getting adequate enough protein. When you lose weight, you're not only losing fat, you can also lose lean mass. So we want you to preserve as much muscle and strength as possible. Your individual protein needs will depend based on your health, kidney function, activity levels, body size, and other factors. So it's important that you talk to your healthcare professional or dietician about what is appropriate for you.

[00:28:03] And just don't simply take the medication and eat as little as possible. Assume as little as possible the importance that you need to get your protein in. So sometimes I see patients where they lose so much weight, but then they're also losing muscle. And it's harder to regain muscle once you lose it. So it's important that you make sure that you're getting your protein in. Number two that you should be doing is you should definitely be exercising or moving your body.

[00:28:29] That includes cardiovascular activity and also at least two days of strength training. Because strength training is especially important as we age because as we lose weight, we can also, you know, lose muscle as well. So it's important that we preserve our muscle, our strength, our function, and independence. And strength training can look very different for everyone. You don't have to walk into a gym and start lifting heavy barbells. No, there are resources that are available for you.

[00:28:57] For example, if you have access to silver sneakers, take advantage of it. There may be fitness centers available to you, online exercise classes, chair-based exercises, a water aerobics, walking programs, and even online programs that you can use. So definitely take advantage of what you have and make sure that you're moving your body. Also, number three, keep your follow-up appointment. Stay engaged with your medical team.

[00:29:25] These medications should not be, here's your prescription, see you next year. We need to be monitoring how much weight you're losing. Are you tolerating the medication? Are you getting adequate nutrition? Are you losing too quickly? Are you maintaining your strength? Are your other medical conditions improving? And should we be increasing the dose, anticipating the treatment, you know, as you go along? So sometimes I've seen people on the same dose for a whole year and they're like, well, I don't understand why not losing weight. I was like, well, because we need to go up on the dose.

[00:29:55] So make sure that you're following up with your doctor. And remember, obesity is a chronic disease. The GOP-1 is just one tool and a larger treatment plan. So what happens after December 31st, 2027? And this is probably going to be one of the biggest questions, especially as we get closer to it. What happens when the BRIDGE program ends? Right now, we don't have all those answers. The Medicare GOP-1 BRIDGE is currently scheduled to continue through December 31st, 2027.

[00:30:25] And therefore, on January 1st, 2028, there will be the balance model that will be in effect. And that will be through Medicare Part D, where they will have additional opportunities to cover obesity medicine. What actually happens after BRIDGE ends? Which plans participate? What eligibility requirements will be? And what patients will pay are still things that we're going to have to watch for. But when I find out, you know you'll find out.

[00:30:53] And I will continue updating you as CMS releases more information. So, in summary, my biggest takeaway after the first month of the BRIDGE is, number one, it is actually easier than it initially sounded. Because it did sound pretty complex. And probably still you may be thinking it is complex. But if we have all the information there, we can help the pharmacist to do what they need. And that we can be able to process that prior authorization. There are definitely nuances.

[00:31:23] There are definitely rules. But it's a pathway. And there are things that you need to know, which is number one, you need to know whether you qualify. Number two, you need to be eligible for Part D coverage. And make sure that you remind your doctor the correct medication and formulation so there's not a hiccup there or takes longer. And make sure that your doctor sends the proper information on there so that you can get the prescription that you need and the pharmacy gets what they need.

[00:31:50] So, make sure the pharmacy has your Medicare number and they'll submit the prescription to the BRIDGE. And then, you know, you meet that eligibility. Then the prior authorization comes to the doctor's office and will complete it. So, if you're listening to this whole episode and you're like, no, this is still pretty complex, just give me the synopsis of what I need to remember. Let me put it in six bullet points. Bullet point number one, know whether you meet your eligibility criteria.

[00:32:17] Number two, make sure you have eligible Part D prescription coverage. Number three, make sure your doctor prescribes the eligible BRIDGE medication. And if it's Zepbound, make sure it's the quick pen and not the injector pen. Number four, make sure that the pharmacy has your Medicare number from your red, white, and blue card. Number five, make sure the pharmacy understands that you're trying to process the prescription through the Medicare BRIDGE and not your Part D insurance.

[00:32:45] And number six, just remember the order of how it's supposed to go. Prescription first, pharmacy BRIDGE claim second, prior authorization third. And then I will give you an additional bonus. Number seven, remember to stay engaged. If you haven't heard anything in about a week, ask them, what's going on? What's the status? And make sure to be cordial and kind and nice to it. Because the old saying, the honey gets more flies than vinegar. Now, once you get your medication, also use that opportunity well.

[00:33:15] Make sure you get your protein, exercise, straight training, and keep your medical follow-ups because that's important. So I hope today's episode makes the Medicare GOP-1 BRIDGE program a little bit less intimidating. And, you know, after working with it, I think the process has become more manageable and it will become more manageable as we go along. And I thank you so much for your time and for listening. And please share this with someone that may be having more difficulties with their BRIDGE experience.

[00:33:44] And until next time, just remember to stay strong, stay committed, stay consistent. And remember, we are stronger together. See you next time.