Does Medicare Cover Aricept?

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 09/10/2018

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Aricept, or its generic form donepezil, is a type of prescription drug. According to Medline Plus, a National Institutes of Health website, this drug may be prescribed to treat confusion and other symptoms in Alzheimer’s patients. Aricept uses might include treatment related to memory or attention span as well.

Is Aricept covered under Medicare Part A or Part B?

If you have Original Medicare (Part A and Part B), you’ll find that Part A generally covers prescription drugs that are administered in an inpatient hospital setting as part of your treatment. Part B would not typically cover Aricept, as Part B typically only covers certain prescription drugs administered to you at a doctor’s office or in another outpatient setting.

Since a beneficiary who uses Aricept might not be in a hospital or outpatient setting, he or she generally needs to look beyond Original Medicare to get coverage for this medication

What part of Medicare might cover prescriptions like Aricept?

Medicare coverage of most of the prescriptions you get at a pharmacy, such as Aricept, may be available to you under Medicare Part D. You may be able to sign up for one of the following types of plan (generally not both):

  • A Medicare Advantage Prescription Drug plan, which has the same benefits as Original Medicare (besides hospice benefits, which are covered through Part A). Some Medicare Advantage plans, called Medicare Advantage Prescription Drug plans, include prescription drug coverage.
  • A stand-alone Medicare Part D Prescription Drug Plan that works alongside your Original Medicare health insurance.

How can I make sure my plan covers Aricept or the generic form, donepezil?

Whichever Medicare Prescription Drug Plan you select, it will have a formulary, or list that shows what medications the plan covers and what your cost-sharing is for each type of drug. You’ll need to check the formulary to see if the plan covers Aricept (generic name donepezil). Brand-name drugs often cost more than generics, so ask your doctor if you need Aricept or if the generic Donepezil will work for your treatment. The formulary may change at any time. You will receive notice from your plan when necessary. It’s a good idea to check that the medications you need are still covered and see if your cost-sharing has changed.

The Medicare Advantage and Prescription Drug Annual Election Period (October 15 – December 7 each year) is generally when you can make certain changes to your Medicare coverage.  For example, you can enroll in, switch or drop a stand-alone Medicare Prescription Drug Plan or a Medicare Advantage Prescription Drug Plan. If you take Aricept or other prescription drugs and want to explore Medicare coverage options, I’m available to help.

  • You can schedule a phone call with me or request an email containing plan information that can help you.
  • See prescription drug plans available in your area by clicking the Compare Plans buttons on this page.

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