Does Medicare Cover Coumadin?

Tamera Jackson by Tamera Jackson | Licensed since 2007

This article was updated on: 09/10/2018

Did your doctor prescribe Coumadin for you? If you’re on Medicare, you may be wondering whether Medicare covers Coumadin. Here’s some information for you.

What is Coumadin?

Coumadin, or its generic form warfarin, is in a class of drugs known as anticoagulants, also called blood thinners, according to the National Institutes of Health. Coumadin may be used to prevent blood clots and to treat certain heart conditions.

Coumadin and Original Medicare

Under Original Medicare (Part A and Part B), prescription drug coverage is restricted to certain situations. Medicare Part A might cover Coumadin or warfarin, if you receive it as part of your treatment in an inpatient hospital setting. Medicare Part B typically covers certain prescription drugs that are administered at a doctor’s office or in a hospital outpatient setting – generally not pills you could take at home on your own, like Coumadin.

Coumadin and Medicare Part D

For most Medicare prescription drug coverage, you need to enroll in a Medicare Prescription Drug Plan under Part D.  This coverage is optional, but if you take prescription drugs such as Coumadin or warfarin, it’s something you might want to consider.

You can get Medicare Part D coverage as either a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan.

When you’re looking for a plan, you might want to check the plan’s formulary, or covered drug list, to see if it covers Coumadin. Every Medicare Prescription Drug Plan has a formulary that lists the medications they cover and what your cost-sharing is for each type of prescription. Brand-name drugs like Coumadin tend to cost more than generic drugs like warfarin. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.  You may also want to check your plan’s Annual Notice of Change, sent every fall, and see if the prescription drugs you need are still covered and if your cost-sharing has changed.

Are you satisfied with your prescription drug coverage for Coumadin or other medications? If you’re looking to switch plans or add a new one, I’m happy to help you sort through the options available to you.

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