Does Medicare Cover Flomax?

Pamela Cannaday by Pamela Cannaday | Licensed since 2011
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This article was updated on: 09/10/2018

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If your doctor has prescribed Flomax, or the Flomax generic equivalent, tamsulosin, you might wonder whether Medicare covers it.

According to the Food and Drug Administration, Flomax is used to treat enlarged prostates in men. Flomax is in a class of drugs called alpha blockers, reports the National Institutes of Health. They work by relaxing muscles so urine can flow more easily.

Flomax and the generic tamsulosin aren’t covered under Original Medicare, Part A and Part B, in most situations. Medicare Part A (hospital insurance) may cover prescription drugs administered as part of treatment in an inpatient hospital setting, so it may cover Flomax (generic tamsulosin) if you’re hospitalized. Part B may cover a limited number of outpatient prescription drugs under limited conditions (generally, drugs administered at a doctor’s office or in a hospital outpatient setting).

Since prescription coverage for Flomax and many other prescriptions is so limited under Original Medicare, you may want to consider enrolling in a Medicare Prescription Drug Plan to have prescription drug coverage. These plans are available from private, Medicare-approved insurance companies. You can get this kind of coverage in one of two ways:

  • Through a stand-alone Medicare Part D Prescription Drug Plan that can work alongside Original Medicare
  • Through a Medicare Advantage Prescription Drug plan, which must provide the same amount of coverage as Original Medicare (Part A and Part B), and also includes drug coverage.

Not every Medicare Prescription Drug Plan necessarily covers Flomax or the Flomax generic, tamsulosin. You can review each plan’s formulary, or list of covered prescription drugs, before making a decision. The formulary may change at any time. You will receive notice from your plan when necessary. Plans may have different premiums, deductibles, copayments, and other cost-sharing factors. Plan pharmacy networks may also vary.

Are you looking for a Medicare Prescription Drug Plan that may cover Flomax? I would be more than happy to help you find a plan in your area that may suit your needs. Just click one of the links below to set up a phone call with me or have me email you some Medicare plan options tailored for you. You can always browse local plans yourself by using the Compare Plans buttons on this page.

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