# How to Enroll in the 2026 Medicare GLP-1 Bridge Program

For decades, millions of older Americans have lived with the clinical and financial burdens of obesity, navigating a health system that broadly recognized the disease's severity while simultaneously denying access to its most effective pharmaceutical treatments. The out-of-pocket costs for glucagon-like peptide-1 (GLP-1) receptor agonists have historically been punishing for those on fixed incomes. Without comprehensive insurance coverage, patients face list prices ranging from $149 to upwards of $1,000 per month, with direct-to-consumer cash-pay discount sites frequently charging $399 to $699 monthly for maintenance doses [cite: 1]. The root of this coverage gap lies in a 2003 statutory exclusion established by the Medicare Modernization Act, which explicitly prohibited Medicare from covering drugs prescribed solely for weight loss, based on an outdated legislative framework that viewed obesity treatments as lifestyle enhancements rather than critical medical interventions [cite: 2, 3, 4]. 

Despite this stringent prohibition, the utilization of GLP-1 medications—originally developed and approved for type 2 diabetes—has skyrocketed within the Medicare population. Between 2019 and 2024, the number of Medicare Part D enrollees using Ozempic surged from under 150,000 to over 2 million, while Mounjaro utilization reached nearly 1 million enrollees shortly after its approval [cite: 5]. Gross Medicare Part D spending on GLP-1s experienced a staggering five-fold increase over the same period, reaching $27.5 billion in 2024, fueled by more than 21.8 million prescription claims [cite: 2, 5]. While negotiated rebates, estimated by MedPAC to hover around 50%, bring net spending closer to $14 billion, the trajectory of expenditure remains a dominant concern for healthcare economists [cite: 2, 5]. As the clinical efficacy of these drugs expanded to include cardiovascular risk reduction and the treatment of obstructive sleep apnea, Medicare was forced to adapt, covering specific formulations for specific diseases, yet leaving isolated obesity systematically untreated [cite: 2, 3, 6]. 

To bridge this massive gap in care without requiring an immediate act of Congress to overturn the 2003 exclusion, CMS has leveraged its demonstration authority to introduce the Medicare GLP-1 Bridge program. Set to launch on July 1, 2026, this program represents one of the most profound shifts in Medicare obesity policy in modern history [cite: 4, 7, 8, 9]. However, its complex administrative framework, stringent eligibility criteria, and explicitly temporary nature require meticulous navigation by health policy analysts, clinical providers, and beneficiaries.

## The Strategic Pivot: From the BALANCE Model to the GLP-1 Bridge

The Medicare GLP-1 Bridge program was not originally conceptualized to stand alone. It was designed as a short-term predecessor to a much larger, permanent initiative known as the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) model [cite: 4, 7, 10]. Under the BALANCE framework, CMS aimed to negotiate comprehensive pricing and coverage rules for GLP-1s, coupling pharmaceutical access with required lifestyle interventions across both Medicaid (beginning in May 2026) and Medicare (beginning in 2027) [cite: 2, 7, 11].

However, the rapid expansion of obesity drug coverage presents severe fiscal risks that fundamentally altered CMS's rollout timeline. The estimated cost to Medicare of broadly covering obesity drugs under Part D ranges between $25 billion and $35 billion over a decade [cite: 11]. Faced with these staggering actuarial projections, major Part D plan sponsors demonstrated deep reluctance to participate in the voluntary BALANCE model, fearing that integrating such high-cost, high-demand therapeutics into standard risk pools would dangerously inflate beneficiary premiums [cite: 11]. Actuarial analyses of commercial markets further underscored these fears, revealing that specialty medications, led prominently by GLP-1s, have grown at a compound annual rate of 17.2%, causing healthcare cost trends to run significantly hotter than previously predicted [cite: 12].

Consequently, on April 21, 2026—just one day after the application deadline for Part D sponsors—CMS announced an indefinite delay of the BALANCE model's integration into Medicare Part D [cite: 10, 11]. To prevent a complete collapse of planned obesity coverage for seniors, CMS utilized Section 402(a)(1)(A) of the Social Security Amendments of 1967, which grants the Secretary authority to test new payment approaches, to extend the temporary Medicare GLP-1 Bridge program through December 31, 2027 [cite: 8]. This extension allows CMS to assume the financial risk directly while collecting vital real-world utilization data to share with hesitant Part D sponsors, theoretically paving the way for future long-term coverage solutions [cite: 7, 8].



## Navigating the Program: FAQ-Worthy Guidelines

Because the Bridge program operates entirely outside of traditional Part D mechanics, understanding the exact parameters of eligibility, covered medications, and enrollment is critical for clinical providers and policy stakeholders. The program fundamentally alters how pharmacies, providers, and the federal government interact regarding obesity care.

### What exactly is the Medicare GLP-1 Bridge Program?
The GLP-1 Bridge is a time-limited demonstration program functioning independently of standard Medicare Part D coverage flows [cite: 8, 13]. CMS has contracted directly with participating pharmaceutical manufacturers to procure eligible GLP-1 medications at a heavily negotiated net price of $245 per monthly supply [cite: 4, 6]. Rather than billing a private Part D sponsor (such as Humana or a Blue Cross affiliate), pharmacies will submit claims for Bridge-eligible patients directly to a single, centralized CMS processor [cite: 8, 13]. This unique architecture ensures that Part D plans bear absolutely zero financial risk for the demonstration, completely isolating the massive costs of the program from 2026 and 2027 premium calculations [cite: 11, 13]. 

### Who is eligible for the $50 GLP-1 copay?
Eligibility is gated by rigorous, multi-tiered criteria designed to target those with the most severe obesity and compounding cardiometabolic health risks. The administrative requirements are precise and unforgiving.

First, the beneficiary must be actively enrolled in a qualifying Medicare Part D prescription drug plan. This includes standalone prescription drug plans (PDPs) or Medicare Advantage coordinated care plans that offer drug coverage (MA-PDs) [cite: 6, 10, 14]. Beneficiaries in Special Needs Plans (SNPs) and employer/union group waiver plans (EGWPs) also qualify, but those enrolled in PACE organizations or private fee-for-service plans without a standalone PDP are ineligible [cite: 6].

Second, the beneficiary must meet stringent clinical criteria *at the time they initiate GLP-1 therapy*. If a patient began therapy prior to July 2026, the prescribing provider must retrospectively attest to the patient's baseline metrics before treatment began [cite: 6]. The specific thresholds require the patient to be at least 18 years old and exhibit one of the following distinct clinical profiles:

| Base BMI Requirement | Accompanying Clinical Diagnosis Required for Eligibility |
| :--- | :--- |
| **BMI ≥ 35** | None. Class II obesity is sufficient for qualification [cite: 6]. |
| **BMI ≥ 30** | Heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (Stage 3a or above), or uncontrolled hypertension (defined as blood pressure >140/90 mm Hg despite two medications) [cite: 6]. |
| **BMI ≥ 27** | Pre-diabetes, previous stroke, previous myocardial infarction, or symptomatic peripheral artery disease [cite: 6]. |

These criteria reflect a form of aggressive utilization management, prioritizing access for seniors at the highest risk of near-term catastrophic health events. Crucially, the medication must be prescribed strictly to reduce excess body weight and maintain weight reduction, in tandem with ongoing lifestyle modifications like structured nutrition and physical activity counseling [cite: 6].

### Which specific medications are covered?
A frequent source of public confusion is the assumption that the Bridge program grants access to all GLP-1 receptor agonists. It does not. The program is strictly limited to formulations that currently possess FDA approval specifically for chronic weight management. Ozempic® and Mounjaro® are absent from the Bridge program entirely, as their primary FDA indications are for type 2 diabetes rather than weight management [cite: 14]. 

To ensure precision in prescribing and claims adjudication, CMS has delineated the exact National Drug Codes (NDCs) authorized under the program. As of the program's announcement, covered drugs include:

| Medication Brand Name | Authorized Formulations | Included National Drug Codes (NDCs) |
| :--- | :--- | :--- |
| **Wegovy® (semaglutide)** | All formulations [cite: 6, 15]. | 0169-4525-14, 0169-4505-14, 0169-4501-14, 0169-4517-14, 0169-4524-14, 0169-4415-31, 0169-4404-31, 0169-4409-31, 0169-4425-31, 0169-4572-14 [cite: 6]. |
| **Foundayo®** | All formulations [cite: 6, 15]. | 0002-4178-31, 0002-4503-31, 0002-4794-31, 0002-4803-31, 0002-4839-31, 0002-4953-31 [cite: 6]. |
| **Zepbound® (tirzepatide)** | KwikPen® formulation only. Single-dose vials and single-dose pens are explicitly excluded [cite: 6]. | NDCs pending final CMS technical release. |

### What are the exact steps for enrollment and prior authorization?
Beneficiaries are not required to actively enroll, register, or opt into the Bridge program on their own [cite: 6]. The administrative burden of access rests entirely on the prescribing healthcare provider. 

Beginning July 1, 2026, a provider must submit a prescription for an eligible GLP-1 drug to a pharmacy [cite: 6]. This action will flag the system and trigger a requirement for a prior authorization (PA) [cite: 6]. The provider must then submit the PA request—either via fax or an electronic portal—directly to the centralized CMS processor, attesting to the patient's BMI and specific comorbidities at the time of therapy initiation [cite: 6, 8, 13]. CMS explicitly notes that prior authorization requests will not be accepted, queued, or processed prior to the July 1 launch date [cite: 6].

## Deconstructing Common Misconceptions

The introduction of the GLP-1 Bridge program into an already complex Medicare Part D landscape is primed to generate widespread confusion. Policy analysts and clinicians must proactively address three pervasive misconceptions regarding the program's coverage scope and financial mechanics.

### Misconception 1: "Medicare now provides comprehensive GLP-1 coverage."
The Bridge program is a narrowly tailored, temporary pathway specifically for weight loss, not a blanket coverage mandate for all GLP-1 usage [cite: 1, 16]. Beneficiaries prescribed GLP-1s for indications already covered under the standard Part D benefit—such as Type 2 diabetes, obstructive sleep apnea (OSA), or noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH)—are strictly prohibited from utilizing the Bridge program [cite: 6].

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For example, if a patient requires Zepbound for the treatment of moderate to severe OSA, or Wegovy to reduce major adverse cardiovascular events in adults with established cardiovascular disease, they must obtain the medication through their standard Part D plan's formulary exception process [cite: 6]. They cannot access the $50 flat copay offered by the Bridge. CMS has stated it will aggressively monitor Part D utilization management practices to ensure private plans do not illegally shift costs by denying standard coverage merely to push patients toward the Bridge program [cite: 6]. Consequently, two Medicare beneficiaries could take the exact same dose of Wegovy, but pay vastly different out-of-pocket costs based solely on the ICD-10 diagnostic code used by their prescriber [cite: 1].

### Misconception 2: "The $50 copayment counts toward my annual catastrophic cap."
Because the GLP-1 Bridge operates entirely outside the Medicare Part D benefit payment flow, the financial mechanics are segregated from the rest of the beneficiary's routine healthcare spending [cite: 8, 17]. 

The $50 monthly copayment does not count toward the beneficiary's annual Part D deductible [cite: 1, 8]. More importantly, neither the $245 negotiated net price nor the $50 out-of-pocket copay counts toward the beneficiary's True Out-of-Pocket (TrOOP) costs or the $2,100 annual out-of-pocket cap on prescription drug costs [cite: 1, 6, 8]. Beneficiaries with extensive pharmaceutical needs will essentially be forced to fund two parallel, non-intersecting out-of-pocket tracks: one for their standard medications that counts toward the cap, and an isolated one for their obesity treatment that accrues endlessly.

### Misconception 3: "Low-income seniors will receive the medication for free."
Perhaps the most concerning equity issue within the GLP-1 Bridge program is the complete exclusion of the Low-Income Subsidy (LIS), widely known as the Medicare "Extra Help" program [cite: 1, 11]. For seniors living near the poverty line who are accustomed to paying $5 to $10 for their covered Part D medications, a flat $50 monthly copay represents a highly significant financial barrier [cite: 1, 8]. Health policy experts point out that while $50 is vastly superior to a $500 retail price, it equates to $600 annually—a massive sum for an individual surviving on a $750-a-month Social Security check [cite: 1]. 

## Comparative Matrix: Standard Part D vs. GLP-1 Bridge

To distill the administrative complexities, the following table explicitly compares the operational realities of a standard Part D prescription versus a prescription processed through the Medicare GLP-1 Bridge. This bifurcation is the defining feature of Medicare's obesity policy for 2026 and 2027.

| Feature / Mechanic | Standard Medicare Part D Coverage | Medicare GLP-1 Bridge Program |
| :--- | :--- | :--- |
| **Program Duration** | Permanent statutory benefit. | Temporary (July 1, 2026 – Dec 31, 2027) [cite: 7, 16]. |
| **Covered Indications** | Type 2 Diabetes, CV Risk Reduction, Sleep Apnea, MASH [cite: 3, 6]. | Weight management (Obesity/Overweight) exclusively [cite: 6]. |
| **Financial Risk Bearer** | Private Part D Plan Sponsors (e.g., Humana, Aetna) [cite: 11, 13]. | Centers for Medicare & Medicaid Services (CMS) [cite: 8, 9]. |
| **Claims Adjudicator** | The beneficiary's specific Part D plan PBM. | A single, centralized CMS processor [cite: 8, 13]. |
| **Out-of-Pocket Cost** | Varies widely by plan formulary tier and coverage phase [cite: 1]. | Flat $50 monthly copayment [cite: 9, 15]. |
| **Part D Deductible** | Costs count toward the annual deductible. | Costs do *not* count toward the deductible [cite: 1, 8]. |
| **TrOOP / Out-of-Pocket Cap** | Costs count toward the $2,100 TrOOP cap [cite: 1]. | Costs do *not* count toward TrOOP [cite: 1, 6, 8]. |
| **Extra Help (LIS) Status** | LIS subsidies apply, significantly lowering out-of-pocket costs [cite: 11]. | LIS subsidies do *not* apply; all beneficiaries pay $50 [cite: 1, 8, 11]. |

## Translating Administrative Timelines into Practical Takeaways

For healthcare providers, clinical administrators, and beneficiaries, the rollout of the GLP-1 Bridge program requires precise logistical timing. Administrative deadlines dictate clinical workflows, and failing to prepare in advance of the launch will result in substantial care delays.

*   **May - June 2026 (The Preparation Phase):** CMS has committed to releasing detailed information regarding the prior authorization processes and distributing the official Medicare GLP-1 Bridge PA fax forms during this window [cite: 6]. During this vital preparation phase, providers should systematically review their patient panels to identify those currently paying cash for weight-loss GLP-1s or those who have deferred treatment entirely due to cost. Providers must locate baseline medical records to verify that patients met the stringent BMI and comorbidity criteria *at the time* they initially started therapy (or will meet them upon starting) [cite: 6].
*   **July 1, 2026 (The Launch):** The single central CMS processor officially begins accepting and processing prior authorization requests [cite: 6, 8]. Pharmacies can begin adjudicating claims for the $50 copayment [cite: 9]. Due to the massive pent-up demand—evidenced by KFF research indicating 50% of surveyed Medicare beneficiaries would be interested in taking a covered GLP-1 for weight loss [cite: 14]—providers should anticipate significant administrative bottlenecks, portal crashes, and processing delays during the initial weeks of July.
*   **December 31, 2027 (The Coverage Cliff):** The Bridge program is explicitly designed to terminate on this date [cite: 7, 8, 9]. The cessation of the program presents a massive clinical risk to the Medicare population. Extensive real-world clinical data indicates that patients who discontinue GLP-1 therapies routinely experience rapid weight regain and a reversal of cardiometabolic benefits [cite: 1]. If the broader BALANCE model is further delayed by CMS, or if standard Part D coverage is not authorized by Congress before this date, millions of seniors could suddenly lose access to life-altering metabolic therapies, resulting in a severe, highly politicized public health disruption [cite: 11, 16].

## Addressing the Ambiguity of the "e212" Document

Within discussions of policy implementation and clinical guidelines for obesity and cardiovascular care, scattered references to an "e212 document" or "e212 memorandum" have frequently surfaced in public discourse, leading some providers to search for specific CMS enrollment forms under this nomenclature. It is vital to apply calibrated uncertainty regarding this specific terminology, as it appears to stem from a widespread bibliographic misunderstanding.

Extensive review of primary CMS directives, federal press releases, and health policy literature yields absolutely no evidence of a centralized, standalone CMS administrative form or policy memorandum titled "e212" related to the GLP-1 Bridge enrollment process. Rather, in the realm of medical literature, "e212" consistently appears as an electronic page number identifier within major academic journal citations that are frequently utilized to justify the clinical need for GLP-1 therapy. 

For example, the 2025 American Heart Association and American College of Cardiology guidelines for hypertension management—a key comorbidity for Bridge eligibility—are formally cited as appearing in the journal *Hypertension* 2025;82(10):e212-e316 [cite: 18, 19]. Similarly, core foundational studies on cardiovascular impacts, incretin mechanisms, and anesthesiology protocols frequently map to an "e212" pagination suffix in digital archives of journals like *Diabetes Care*, *Circulation*, and *The Lancet Infectious Diseases* [cite: 20, 21, 22, 23, 24, 25]. 

Therefore, until CMS releases its finalized prior authorization forms in June 2026, stakeholders should operate under the assumption that references to "the e212 document" are likely bibliographic artifacts stemming from clinical guidelines used to justify the treatment of cardiovascular and metabolic comorbidities, rather than a specific CMS enrollment form. Providers should rely strictly on the forthcoming CMS-branded prior authorization portals and fax forms, which are expected to be published directly on the official Medicare GLP-1 Bridge webpage.

## The Broader Implications: Fiscal Constraints and the Obesity Epidemic

The creation of the GLP-1 Bridge program cannot be viewed in a vacuum; it is merely a symptom of a much larger macroeconomic struggle to balance revolutionary medical advancements with systemic financial sustainability. The unprecedented demand for incretin therapies is fundamentally reshaping healthcare economics across both public and private sectors.

The historical costs of GLP-1 medications have consistently overwhelmed public payers. In 2024, Medicaid gross spending on GLP-1s reached almost $9 billion for approximately 8 million prescriptions, averaging roughly $1,000 per prescription prior to state rebates [cite: 3]. This immense financial pressure has forced states into a period of severe clinical retrenchment. As of January 2026, only 13 state Medicaid programs continued to cover GLP-1s for obesity treatment under fee-for-service models, down from 16 states just months prior [cite: 3, 11]. States facing tighter budget conditions and long-term fiscal uncertainty, exacerbated by federal Medicaid cuts in the 2025 reconciliation law, are aggressively re-evaluating their coverage [cite: 3]. For instance, states like California, Pennsylvania, New Hampshire, and South Carolina completely eliminated obesity coverage due to budget shortfalls, while North Carolina suffered a temporary elimination due to a legislative budget stalemate [cite: 3].

Medicare faces the exact same fiscal math, magnified exponentially by the sheer size of its beneficiary pool. While the Bridge program successfully secures a net price of $245 per month—a substantial discount from retail cash prices—the volume of potential users threatens to outstrip these savings [cite: 4, 6]. Actuaries note that despite high initial costs, real-world evidence demonstrates that GLP-1 users show lower long-term medical trend rates, including a 44% decrease in hospitalizations for major adverse cardiovascular events (MACE) [cite: 12]. Furthermore, adherence to GLP-1 therapy has improved remarkably, with over half of users meeting the clinical standard of >80% Proportion of Days Covered (PDC) [cite: 12]. 

However, these long-term clinical savings may take years to materialize, while the upfront costs are immediate. By operating the Bridge program outside of Part D, CMS has temporarily insulated private Medicare Advantage and standalone PDP sponsors from a financial shock that could have destabilized premiums across the board [cite: 11]. This insulation is entirely temporary. The aggressive collection of utilization data through December 2027 is intended to give actuaries the historical cost baselines necessary to accurately price these drugs into future Part D bids under the anticipated BALANCE model [cite: 7, 11]. Whether those future bids will ultimately be affordable for the government or the taxpayer remains one of the most pressing questions in modern health economics.

## Bottom Line

The Medicare GLP-1 Bridge program represents a highly structured, temporary workaround to a decades-old statutory ban on obesity medications. For eligible beneficiaries with severe obesity and compounding cardiometabolic comorbidities, the program offers a vital lifeline to life-changing metabolic therapies at a predictable $50 monthly copay. However, its strict administrative silos, its complete exclusion from standard Part D out-of-pocket maximums, and its impending, hard expiration in December 2027 demand that both providers and patients approach the program with cautious optimism. It is not a permanent cure to the Medicare coverage crisis, but rather a precarious, 18-month stopgap that requires flawless logistical navigation while the broader healthcare system grapples with the economics of modern obesity care.

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15. [roseins.com](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFEa0ryJwgPaV84xU9BTaJ3-RRlCZHF7_UJcJnLe_taEyQ2IEdjdaK55MfCz9ywMs6PY9Bbe48gU9mXf_6EGQBmbaKeVQ75V0oWi4oT5X34ISj0aDwJKvuNJ5uzR65sr_wOufqZvllY6GFNznER2djclZDnQy-DdTcnklb8YMuKVxzII-NoKB0Ujdjuj4GDdNsZSNZLG4YEuAk=)
16. [obesityaction.org](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQH9SrvCzxWRgvO5x4Km34vhI8mlE3ZW1s9-38AZQeuDDS3o-ynAYaBBFDCVN9hbKLQ0Psm6MCXqRj8Ik9RReCPV96aFRfK5JlbQb1ohwpl6K0nNr0XkPfuBQR7ZFUjuXc2jUtdYANGL6V6Tkq7EHpjMoMVknXiYbpz2jZnz0g5NmbW649k8v-B215NhaQ==)
17. [humana.com](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFIBiHj5KpIdfnoiHS4UIquqcQvbzC6SrfDZIfyUrbhbEXL1MwscfVeRLeAyUYlkiuOKM9QfclKCXWje_2QRe6ikZRsSbFOsP8UQbQ0rIr4DmsdPEe1V7gjYpumdI1ienPoHTWdIQKStDz5HVHdbRIt9i5Z9ndXdfa8NjH8DhhkjHvTb_SCVm-VhZWLcnca)
18. [ama-assn.org](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQENKBobB2BzZzrULdCJ1Zz0khTSVBL6_BJEy2oZ8KVk2c3M9RgMLozB9Akbr0c_5wyY3cUtTuAx_Hxxl_7oilMbX87A3Crf-UQzTx-b_oIklEdbBStFfiBzStOfYgQzkFS-2ErB2xuXykJTwkf-Em2iJqRJi9ky)
19. [ahajournals.org](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQF9rn6cD-Vo9tTLCAeRYkAljXVkuF1qQt0A-dV989RKLWEyQQTDuKp7kP931a4wT-eBGUZI9qdY3EyeXNRbJGmw0gtralpFXqQUlLd-aT_2hwDvSIvy-8lQLFv5D1tEZzJS82TMNaVZCOWkMfhAQdp2GMI=)
20. [nih.gov](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEpcU_ci8Kjee4Sh6kOPNHpULT0HRzY0Mf1dPmgTb_J6iA0agpgkoU1dhG7q9uqe0NuQKyqq-TuThqyaLPVG0ohIcjTXuP29t3EckkuTwTRC8K314oqtUycN17xhCUSFngg_H2O6va-8Q==)
21. [uscjournal.com](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFaBNqEQtpx3LOyBvknvoDAaoUycN62mj2XaCDokw-cZTJ7Qm8XguSv1jpu9reRGvbngSeFmhaxP0xu0ZR9FT5zugwJt_FkxJr-os32JekyT0m20ubHieKS_mOzkDQr94WHdcCTrYnCjnlPt4UDqcHC0x8gP4eKjcN2aj46X_cCc_2IfpiTJnXL6CPS029pFDAKowe0jlNbpC1wPsD_Q69QfYHj06q-4H7mIDL31Ip0ohNYTli60vlXUK_8bjmv654U3gXXlgKan6oqi72i)
22. [ahajournals.org](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFB8WGDApBbcB-GJhQPZftqDbgSIAsHDr2K_PlSooAxcDF4qklgsNChN04TFBkdM-8CNeWKqJDmF5RwaddWUsZ30DJ3I4oznt2-GVCWbt-7KLr8maWP1Z7ISpPtnlMi-w4NaPSXWBIiz37wqtiOrLahsv0=)
23. [ascopubs.org](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQH3_OmtJrrEfbfQU_r7m-cCxMkxxEtsVtMiMvFQZ92Xv0wznOr9rZ82TS0pDcbqXrdL2C-QWMFPlVJrPb_RUCRmE-5ZkVKDgkIJJEctG8986AOa5DbAf5T6vyxtAY3s9BArEoo=)
24. [oup.com](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQGv5EXZ6VTR3HdjEN4kMqw1-r6J75zChjggzppGtdGe34VIPyJrwdOzchcx_VMzfBwW4gC8S2S-T_M7LhznZFXSrWOonj1n24U2qvigtRbbljl9waUCNowZw9JZAWYqNiYuaCzgedXvbCAnJSFf)
25. [nih.gov](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQH3Slim43LjgXGk-ak1WzDCPW1nFSy0yIdKHODc2FN2mdgeQKJwxCWwXdXhejY_3GrpbF4HTh-H5W15RmQutp_X83vqHKZZAiiYJ6MBEB2SQq1Ynf678eXv3hvRgd3LfPq3Lh5RIvKD)