7/1/2026

Have a statement and want to pay your bill? Go to www.paymydoctor.com

Don’t have your statement or have questions for the billing department? Call 248-267-6797

We are aware that the Medicare Bridge Program for GLP-1 medications will be starting 07/01/2026.  In order to receive a GLP-1 medication through the Medicare Bridge Program you MUST have a prior authorization submitted and approved.

In order for Troy Internal Medicine to process your prior auth, you MUST meet one of the following indications.

INDICATIONS:

1.  BMI equal to 35 or greater with diagnosis of obesity

OR

2.  BMI equal to 30 or greater WITH a diagnosis of (1) or more of the following:
a.  Heart failure with preserved ejection fraction
b.  Uncontrolled hypertension (BP >140 mm Hg systolic OR diastolic BP >90 mm Hg documented)
c.  Chronic kidney disease stage 3a or above

OR

3.  BMI equal to 27 or greater with (1) or more of the following:
a.  Pre-diabetes as defined by American Diabetes Association guidelines
b.  Previous myocardial infarction
c.  Previous stroke
d.  Symptomatic peripheral artery disease

If you are interested in the Medicare Bridge Program (and you feel that you meet ONE of the above indications) please send a web message to our office.  In the subject line put “Medicare Bridge Program”.

1.  For CURRENT GLP-1 users – a new prior auth will be needed for this program.
a.  We will review your information chart to see if you indeed meet the one of the indications – and may schedule an office visit to update documentation as needed.

2.  NEW GLP-1 users will need to schedule an OV with either a PA or our NP.  We will coordinate this for you after receipt of your web message.  If you have any upcoming appointment with a provider within the next (6) weeks, a discussion will be held with your provider in order to initiate
the prior auth process.

Please note that this process is a work in progress.  Medicare has been vague it is documentation requirements (other than the indications required).  We are NOT aware of how timely the insurance will be in approvals, etc.  Your patience is greatly appreciated as we navigate the process.