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To be eligible for the plan, members must: Be enrolled in a standalone prescription drug plan (PDP), like Part D, or a Medicare Advantage (MA) plan Use GLP-1 medications to treat excess body weight and maintain weight loss Meet all clinical criteria Clinical criteria for Medicare GLP-1 Bridge program To qualify clinically, a health care provider must submit a prior authorization stating the medication is prescribed to “reduce excess body weight and maintain weight reduction.” The medication must also be used alongside “current and ongoing lifestyle modifications,” including a nutrition plan and consistent physical activity
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