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Does Medicare Cover Paxil?

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According to the National Institutes of Health (NIH), Paxil is one brand name for a generic medication called paroxetine, which may be used to treat conditions such as:

  • Depression
  • Panic disorder
  • Social anxiety disorder
  • Obsessive-compulsive disorder

Since Original Medicare Part A and Part B only cover prescriptions in specific instances, they might not cover your Paxil prescription. To cover this prescription, you may want to consider a Medicare Prescription Drug Plan.

What is Paxil?

Paxil comes in different forms, such as an extended-release tablet, a regular tablet, and a liquid, reports the National Institutes of Health (NIH). Pharmacists classify this prescription drug as a selective serotonin-reuptake inhibitor (SSRI). Its primary use is to help manage symptoms of depression and other mood disorders. Doctors may also prescribe Paxil to help their patients cope with symptoms of menstrual and menopausal problems. This medicine works by elevating the amount of serotonin in the brain, says the NIH; this naturally-occurring substance helps regulate mental balance.

Will Medicare cover Paxil?

Part A and B of Original Medicare don’t typically cover prescriptions that you take at home. Part A might cover Paxil if it’s given to you in the hospital or another inpatient setting as part of your treatment. Typically, Part B only covers prescriptions that providers administer in an outpatient facility and aren’t usually the kinds of medicine that patients administer themselves.

But there is prescription drug coverage available from private, Medicare-approved companies under the Medicare Part D program.

  • You may enroll in a stand-alone Medicare Part D Prescription Drug Plan if you’re enrolled in Medicare Part A and/or Part B.
  • If you prefer, you may be able to get your prescription drug benefits and your Medicare Part A and Part B benefits in a single plan: with a Medicare Advantage Prescription Drug plan. Medicare Advantage plans administer your Medicare benefits except for hospice care, which still come directly from Part A instead of through your plan. You must continue to pay your Part B premium, as well as any premium the plan may charge.

With either type of plan described above, you need to live within the plan’s service area. You can find out if your plan covers Paxil or paroxetine by reviewing the plan’s formulary, or list of covered prescription medications. These formularies can change at any time, but your plan will notify you when necessary.

Our Licensed Insurance Agents can help you to:
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