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Does Medicare cover the epilepsy medication Neurontin? Original Medicare, which consists of Medicare Part A and Part B, doesn’t usually cover Neurontin (except in certain situations described below). In order to cover this prescription medication, you typically need to enroll in a stand-alone Medicare Part D Prescription Drug Plan. A different option is to enroll in a Medicare Advantage Prescription Drug plan.
What is Neurontin?
Doctors might also prescribe Neurontin, an anticonvulsant, under the generic name of gabapentin. Either way, this prescription drug comes as a tablet, capsule, or oral solution, according to the National Institute of Health (NIH). The NIH shared some uses of this prescription:
- Patients may receive this prescription in order to help control epileptic seizures
- Neurontin can relieve pain from postherpetic neuralgia, a complication of shingles.
- Doctors also prescribe extended-release tablets of Neurontin to help patients control the symptoms of restless leg syndrome.
How Medicare might cover Neurontin
Typically, Medicare beneficiaries get prescriptions for Neurontin filled at a pharmacy and then take the medication at home. Generally, Original Medicare (Part A and Part B) don’t cover medications you take this way. These are some circumstances that might allow Original Medicare to cover a prescription:
- Medicare Part A covers prescription drugs that inpatient facilities provide as part of treatment.
- Medicare Part B covers certain prescriptions that outpatient facilities directly administer.
In other words, an oral medicine that patients fill at their pharmacies won’t usually be covered by Original Medicare. You typically need to enroll in a Medicare Prescription Drug Plan in order to get a prescription drug like Neurontin covered.
Medicare Part D coverage of Neurontin
There are generally two different ways to get Medicare prescription drug coverage. Both kinds of plans are available from private, Medicare-approved insurance companies.
- You can enroll in a stand-alone Medicare Part D Prescription Drug Plan. You need to be enrolled in Medicare Part A and/or Part B, and live within the plan’s service area.
- Some Medicare Advantage plans also offer prescription drug coverage. You need to be enrolled in both Medicare Part A and Part B, and live within the plan’s service area.
These plans have formularies, or lists of covered drugs. For example, the insurers might cover a brand-name medication like Neurontin differently than it covers the generic form – if they cover Neurontin at all. Also, plans reserve the right to change their formularies at any time, but they must give enrollees notice of any changes.
Has your doctor prescribed Neurontin, gabapentin, or a similar prescription drug? If so, you might want to search for a Medicare Prescription Drug Plan to help cover the cost. I am here to help you find a Medicare plan option that may suit your needs. This is how you can get started:
- You might arrange a phone call or have me email you information by clicking on the Get Quotes button on this page