The age rule is 18 or older, so age 80 alone does not exclude you. You need both a prescription and advance approval.
You must also have a Medicare medicine plan that meets these rules. It may be a Part D plan on its own, or Medicare Advantage with coordinated care and medicine cover.
The weight and health checks use your situation when treatment began; BMI is the weight measure used in these rules.
Ask your prescriber, the person writing your prescription, to compare your BMI and diagnosis records with these three choices:
- BMI of 35 or higher.
- BMI of 30 or higher, plus a listed heart, blood-pressure or kidney problem.
- BMI of 27 or higher, along with pre-diabetes (blood sugar raised before diabetes), a heart attack or stroke in the past, or symptoms caused by poor blood flow in the limbs.
For the middle choice, only one type of heart failure is on the list. Its diagnosis name is “heart failure with preserved ejection fraction.”
Bring the name from your medical records so the prescriber can check whether it matches.
For the blood-pressure choice, the upper reading must stay above 140 or the lower one above 90 mm Hg, even with two blood-pressure medicines. Blood pressure is measured in mm Hg.
The kidney choice means disease at stage 3a or higher, a level recorded in your diagnosis.
Type 2 diabetes or moderate to severe sleep apnea rules out the Bridge because those uses go through the usual Part D plan instead.
One particular fatty liver condition also rules it out. The diagnosis must be the type named MASH, with moderate to advanced liver scarring and without the separate diagnosis called cirrhosis.
A diagnosis of fatty liver by itself does not settle this rule; the prescriber needs to check the full diagnosis.
Having a GLP-1 medicine paid for by Part D in 2026 bars you from the Bridge during 2026. The recorded rules have not yet set this check for 2027.
The prescription must be part of ongoing changes in food and physical activity, with organised support for those changes.
