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[DOI] [PMC free article] [PubMed] [Google Scholar] 40.Camacho-Pereira J., Tarrag M.G., Chini C., Nin V., Escande C., Warner G.M., Puranik A.S., Schoon R.A., Reid J.M., Galina A., et al

CMS BALANCE Model & Medicare Changes CMS announced the BALANCE Model on December 23, 2025, expanding Medicare/Medicaid GLP-1 access: [16] July 2026: Medicare GLP-1 Payment Demonstration begins$50/month out-of-pocket for eligible beneficiaries MayDec 2026: State Medicaid programs can join BALANCE on rolling basis January 2027: Medicare Part D plans begin full BALANCE participation Anthem Medicare Advantage plans may participatecheck with your plan in mid-2026