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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