Open dataset · Monthly and after CMS or plan changes
GLP-1 Coverage and Prior-Authorization Evidence Tracker
No national approval-rate estimates are published without a disclosed sample and methodology.
Key findings from FormBlends Research
FormBlends Research finding 1
#Public program eligibility is not the same as an approval-rate estimate.
FormBlends Research finding 2
#The Medicare GLP-1 Bridge creates a time-bounded national access pathway for eligible beneficiaries.
FormBlends Research finding 3
#FormBlends should not publish PBM-specific percentages until the underlying sample is reproducible.
The data
| Program | Status | Population | Published benefit | Unknowns | Source |
|---|---|---|---|---|---|
| Medicare GLP-1 Bridge | Active beginning July 1, 2026 | Eligible Medicare Part D beneficiaries | $50 monthly access to certain GLP-1 drugs | Individual eligibility and covered product | Centers for Medicare & Medicaid Services |
| Ro insurance check | Provider-published service | Ro prospects seeking select GLP-1 coverage | Free coverage check published | Plan-specific outcome and prior-authorization decision | Ro |
| FormBlends proprietary approval-rate dataset | Not published | None until methodology is complete | No rate reported | Sample, payer mix, dates, numerator, denominator, exclusions | FormBlends |
Methodology
- 1. Prefer CMS, plan documents, and manufacturer coverage tools.
- 2. Separate eligibility rules from observed approval rates.
- 3. Do not infer national coverage from a provider’s patient sample.
- 4. Publish numerator, denominator, dates, payer mix, and exclusions before reporting proprietary rates.
Limits
- • Coverage is plan- and indication-specific.
- • This tracker does not guarantee coverage or replace a benefits determination.