Does Medicare Cover Apresoline?
This article was updated on: 05/28/2019
Apresoline (the generic form is called hydralazine) is a vasodilator, a class of drug often used to treat high blood pressure and occasionally heart failure, according to the National Institutes of Health’s Medline Plus website. Apresoline works by relaxing the blood vessels, making it easier for blood to circulate throughout the body. Original Medicare (Part A and Part B) doesn’t cover treatment with Apresoline, apart from specific situations described below. Read more about Medicare coverage of Apresoline below.
How can I get Medicare coverage for Apresoline?
Original Medicare (Part A and Part B) generally does not cover prescription medications such as Apresoline when you take them at home. Medicare Part A may cover prescription drugs when you receive them as an inpatient during a qualified hospital stay. Medicare Part B may cover certain drugs administered to you as an outpatient – for example, in a clinic; these are generally drugs you wouldn’t take on your own.
In order to get Medicare coverage for prescription drugs such as Apresoline, you can sign up for Medicare prescription drug coverage under the Medicare Part D program. You’d need to find a plan that specifically covers Apresoline or hydralazine.
There are generally two ways to get Medicare prescription drug coverage:
- You can enroll in a stand-alone Medicare Part D Prescription Drug Plan to complement your Original Medicare coverage and certain other types of Medicare health plans.
- You can enroll in a Medicare Advantage Prescription Drug plan.
If you want Medicare coverage for prescription drugs such as Apresoline, it’s important to enroll as soon as you are eligible. If you wait to sign up, you may have to pay a late-enrollment penalty with your monthly premium for as long as you have coverage.
Stand-alone Medicare Part D Prescription Drug Plans and Medicare Advantage Prescription Drug plans are offered by private companies contracted with the Medicare program to offer these benefits.
If you want to enroll in a Medicare plan that includes prescription drug coverage to cover Apresoline, and your Medicare Initial Enrollment Period has passed, read about election periods when you can sign up.
Keep in mind that all plans may not be available in all locations. Plan benefits, premiums, deductibles, coinsurance and copayment amounts may be different depending on where you live and the type of plan you select.
Which plan option should I choose for Medicare coverage of Apresoline?
Some Medicare beneficiaries prefer to stay with Original Medicare, Part A and Part B, and add a stand-alone Medicare Part D Prescription Drug Plan that includes coverage for drugs such as Apresoline. If you decide to stay with Original Medicare, another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.
Or, you might prefer the convenience of a Medicare Advantage Prescription Drug plan that covers Apresoline. Medicare Advantage plans are an alternative way to get your benefits under Medicare; they’re required to cover everything that Original Medicare includes, except for hospice care, which is still covered under Part A. Many Medicare Advantage plans offer additional benefits, such as:
- Coverage for routine dental, hearing, and vision care, including prescription eyewear
- Coverage for wellness programs
- Discounts on certain over-the-counter medications
- Discounted gym memberships and other services
Not all Medicare Advantage plans offer these extra benefits, and not all plans are available in all areas. You must continue to pay your Part B premium, plus any additional premium your plan requires if you choose Medicare Advantage. Premiums may vary among plans; some Medicare Advantage plans have premiums as low as $0.
Each Medicare plan that includes prescription drug coverage uses a formulary, or list of covered medications, to determine benefits. If you want Medicare coverage for Apresoline or hydralazine, be sure to check the plan’s formulary to see if it’s included before you select a plan. Note, however, that plans may change their formularies occasionally, you will receive notice from your plan when necessary.
I’m available to help if you’d like more information about Medicare coverage, including helping you find a plan that covers Apresoline. You can request information via email or schedule a phone call at your convenience by clicking one of the links below. To see a list of plans in your area, click the Compare Plans or Find Plans button.