Medicare's pilot GLP-1 discount program has a catch. Some sick patients don't qualify

In January, Jeff La Marca got a prescription for the popular weight loss drug Zepbound, but he couldn't afford the $750 monthly price tag. Erica S. Lee/KFF Health News hide caption

In January, Jeff La Marca got a prescription for the popular weight loss drug Zepbound. But he couldn't afford the $750 monthly price tag.

This story was produced in partnership with KFF Health News .

Then Medicare launched an 18-month pilot program that offers GLP-1 medications to some enrollees for only $50 a month. La Marca thought he might finally be able to afford the drug.

"I thought, 'Thank God, there's a path,'" said La Marca, who lives in Basking Ridge, N.J., and has tried numerous diets and exercise regimes.

La Marca has severe obstructive sleep apnea, one of several diagnoses that exclude patients from the Medicare GLP-1 Bridge program's $50 monthly price.

The notification didn't say why he was rejected. He thinks that if he didn't have that diagnosis, he would qualify due to his weight.

"I'm obese, morbidly obese, BMI 42. I had quadruple heart bypass surgery. I'm at risk for stroke. I'm prediabetic. And yet I can't get it. I'm livid," he said.