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

One month into the Medicare GLP-1 Bridge program, I've learned that getting approved is less complicated once you understand the pathway. But there are several important details that can cause delays if you don't know what to look for. In this episode, I walk you through what I've learned from helping patients navigate the Medicare GLP-1 Bridge during its first month. We cover who qualifies, which medications and formulations are included, when you may need to use Medicare Part D instead, and what your doctor, pharmacy, and you need to do to keep the process moving. I'll also explain why your current BMI may not be the BMI that matters, why the pharmacy claim needs to happen before the prior authorization, and why staying engaged with both your pharmacy and doctor's office can make a difference. And once you actually get your medication, I shift the conversation to what you should be doing to maximize your results, including getting adequate protein, moving your body, strength training, and staying engaged with your medical team. If you're trying to navigate the Medicare GLP-1 Bridge program for yourself or a loved one, this episode will help you understand the process and the questions you need to ask. Episode Highlights: ● What the Medicare GLP-1 Bridge program is and how it differs from Medicare Part D ● The three main eligibility pathways for the Bridge program ● Why your BMI when you started GLP-1 therapy may matter more than your current BMI ● When certain medical conditions may require you to use the regular Medicare Part D pathway ● Why having eligible Medicare Part D coverage matters ● Which GLP-1 medications and formulations are included in the Bridge program ● Why the correct Zepbound formulation matters ● What your pharmacy needs from your Medicare information ● Why the pharmacy claim needs to happen before the prior authorization ● How to follow up when your prescription seems stuck in the process ● What to focus on once you actually receive your medication ● Why protein, exercise, strength training, and medical follow-up remain important ● What we currently know about what happens when the Bridge program ends   Connect with Dr. Alicia Shelly Website | drshellymd.com Facebook | www.facebook.com/drshellymd Instagram | @drshellymd Linked In | www.linkedin.com/in/drshellymd Twitter | @drshellymd About Dr. Alicia Shelly Dr. Alicia Shelly was raised in Atlanta, GA. She received her Doctorate of Medicine from Case Western Reserve University School of Medicine in Cleveland, OH.  Dr. Shelly has been practicing Primary Care and Obesity medicine since 2014.  In 2017, she became a Diplomat of the American Board of Obesity Medicine. She is the lead physician at the Wellstar Medical Center Douglasville. She started a weekly podcast & Youtube channel entitled Back on Track: Achieving Healthy Weight loss,  where she discusses how to get on track and stay on track with your weight loss journey. She has spoken for numerous local and national organizations, including the Obesity Medicine Association, and the Georgia Chapter of the American Society of Metabolic and Bariatric Surgeons. She has been featured on CNN, Fox 5 News, Bruce St. James Radio show, Upscale magazine, and Shape.com. She was named an honoree of the 2021 Atlanta Business Chronicle's 40 under 40 award. She also is a collaborating author for the, "Made for More: Physician Entrepreneurs who Live Life and Practice Medicine on their own terms''. Resources: FREE! Discover the 5 Reasons Your Weight-Loss Journey Has Gotten Derailed (And How To Get Back On Track!) 👉 Click HERE