Does Medicare Cover Glucophage?

Mike Olmos by Mike Olmos | Licensed since 2010

This article was updated on: 09/10/2018

Original Medicare (Part A and B) typically doesn’t cover prescription drugs like Glucophage. Generally, you’d need a Medicare plan that includes prescription drug coverage if you want help paying for medications that you fill at the pharmacy and take at home.

What is Glucophage?

You might also know this prescription medication by its generic name of metformin. Doctors sometimes prescribe Glucophage to help control high blood sugar (glucose) for patients with type 2 diabetes, according to the National Institutes of Health’s Medline Plus website. The prescription medication helps to both control the amount of sugar absorbed from food and the amount produced by the liver. In addition, this prescription drug boosts the body’s response to insulin. Your doctor might also recommend other prescription drugs and a diet and exercise routine to help control your blood sugar.

How Medicare may cover Glucophage (metformin)

Original Medicare (Part A and B) typically doesn’t cover prescription drugs except in certain situations. In general, Part A only helps to pay for prescriptions that you get as part of inpatient treatment in a hospital, hospice, or similar inpatient facility. Part B offers some coverage of certain prescriptions that medical providers deliver inside a clinic or other outpatient setting. This coverage excludes most prescriptions that you fill in a pharmacy and then take home to take on your own.

Medicare beneficiaries may choose a Medicare plan that includes prescription drug coverage that is offered by private insurance companies contracted with Medicare. These plans might help cover the costs of medications, including Glucophage.

  • If you’d like to remain with Original Medicare, you could enroll in a stand-alone Medicare Part D Prescription Drug Plan.
  • A second option is to enroll in a Medicare Advantage plan. Medicare Advantage is an alternative way to receive your Original Medicare benefits (except for hospice care, which Part A will still provide). Most Medicare Advantage plans include prescription drug coverage (Medicare Advantage Prescription Drug plans).

You may want to check the formulary of any stand-alone Medicare Part D Prescription Drug Plan or Medicare Advantage Prescription Drug plan that you consider. The formulary tells you which drugs are covered and how they are covered. Of course, insurers may make changes to their formularies at any time, but they must notify you about any changes in advance when necessary.

Would you like some help finding a Medicare plan that helps you pay for Glucophage or other prescription drugs? You can get assistance by choosing one of these steps:

  • Schedule a call or have me email information by clicking a link below.
  • Research Medicare plan options in your town or city – just click on the Compare Plans button or the Find Plans button on this page.

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