Does Medicare Cover Laxatives?

Last Updated : 11/08/20193 min read

Generally Medicare does not cover over-the-counter medications, including laxatives that do not require a prescription. However, a Medicare Part D Prescription Drug Plan may cover laxatives prescribed by a doctor or other authorized health professional.

What are laxatives and when are they used?

A laxative is a substance meant to help a person have a bowel movement, according to the National Institutes of Health.

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Laxatives are used to relieve and prevent constipation, which occurs when it is difficult to have a bowel movement.

Sometimes exercise, or adding more water, fiber, fruits, and vegetables to a diet are enough to help you avoid problems with constipation, according to the Mayo Clinic. If these natural methods don’t work, your doctor might recommend a laxative. Stool softeners can also help relieve constipation.

A variety of medicines for constipation are available. As the Mayo Clinic explains, the primary types of laxatives include:

  • Oral stool softeners, such as Colace, which work by adding moisture to the stool to soften it and ease passage.
  • Oral osmotics, such as Phillips’ Milk of Magnesia, which draw water into the colon to ease stool passage.
  • Oral bulk formers, such as Metamucil, which absorb water to form a soft, bulky stool, prompting normal contraction of intestinal muscles.
  • Oral stimulants, such as Dulcolax, which trigger rhythmic contractions of intestinal muscles to eliminate the stool.
  • Rectal suppositories, which also prompt rhythmic contractions of the intestinal muscles to remove the stool. Dulcolax is available as a suppository.

Laxatives and stool softeners have a variety of side effects and generally should not be taken for extended periods of time, the National Institutes of Health cautions. You should consult your doctor to determine which type of laxative (if any) may be best suited to your condition and how frequently you should take the laxative. Be sure to inform your doctor of other medications you take. The Mayo Clinic notes that laxatives may react adversely with certain medications or may delay treatment of an underlying problem, such a bowel obstruction or an appendicitis, by masking the symptoms of the condition.

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When are laxatives for the relief of constipation covered by Medicare?

If you’re enrolled in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, your plan may cover laxatives or stool softeners prescribed by your doctor to treat constipation. Generally, the prescribed laxative must be on the plan’s formulary (the plan’s list of covered medications) and a medically necessary treatment. To find out if prescription medicine for constipation is covered, refer to your plan’s formulary or contact the plan’s customer service department. The formulary may change at any time. You will receive notice from your plan when necessary.

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