Does Medicare Cover Dilantin?

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/10/2018

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If you take Dilantin (the generic name is phenytoin) and are a Medicare beneficiary, please know that Original Medicare offers limited coverage of prescription drugs. According to the U.S. National Library of Medicine, Dilantin or phenytoin is used to control certain types of seizures. Dilantin is also used to treat and prevent seizures that may start before or after brain/nervous system surgery.

If you’d like help with the costs of Dilantin, you can consider enrolling in a Medicare plan that includes prescription drug coverage, and specifically Dilantin—learn more in this article.

Original Medicare benefits and Dilantin

Medicare actually consists of several components and options. If you understand the different benefits and parts of Medicare coverage, that knowledge goes a long way in knowing your eligibility coverage and accessing the benefits. It also helps to determine whether Medicare covers Dilantin. Please note that Original Medicare (Part A and Part B) typically doesn’t cover prescriptions you take at home.

Medicare Part A (hospital insurance) covers prescription drugs administered to you by a health-care professional while you are an inpatient in the hospital. Medicare Part B (medical insurance) covers outpatient medical care for Medicare beneficiaries, and covers some prescription drugs that are administered while you are in an outpatient medical clinic or doctor’s office.

Medicare plans that include prescription drug coverage and might cover Dilantin

If you need help with prescription drug costs, you might consider enrolling in a Medicare plan that includes prescription drug coverage for Dilantin. If you decide to remain with Original Medicare, you can enroll in a standalone Medicare Part D Prescription Drug Plan.

Another option is to enroll in a Medicare Advantage Prescription Drug plan. Medicare Advantage is an alternative way to receive your Original Medicare benefits (except for hospice care, which Part A still provides). Please note that you’ll still need to pay your Medicare Part B premium, along with any premium the Medicare Advantage plan requires, in addition to copayments, coinsurance, and deductibles.

Whichever Medicare plan option you choose, you may want to check to see if it covers your Dilantin. Medicare plans that include prescription drug coverage each have a formulary, or list of medications that are covered. Please note that the formulary may change at any time; however, your plan will notify you of changes when necessary.

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