Does Medicare Cover Lexapro?

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 09/10/2018

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Did your doctor prescribe Lexapro for you? If you’re on Medicare, you might be wondering about the benefits of Lexapro and how much it costs.

What are the benefits of Lexapro?

If you have depression or anxiety, your doctor may prescribe Lexapro, or its generic form escitalopram. The National Institutes of Health reports that this drug belongs to a class called selective serotonin reuptake inhibitors (SSRIs). It works by boosting your serotonin levels – this is a naturally-occurring substance in your brain that helps maintain mental balance.

Lexapro and Original Medicare

You’ll probably need more than just Original Medicare (Part A and Part B) if you want coverage for Lexapro or its generic equivalent, escitalopram. Typically, Part A covers medications given to you to treat your condition as a hospital inpatient. Medicare Part B may cover prescription drugs administered at a doctor’s office or in a hospital outpatient setting.

Lexapro and Medicare Part D

To get help paying for prescriptions like Lexapro or escitalopram, you can generally enroll in prescription drug coverage under Medicare Part D. This coverage is available as either a Medicare Advantage Prescription Drug plan or a stand-alone Medicare Part D Prescription Drug Plan that works alongside Original Medicare. Both kinds of plans are available from private, Medicare-approved insurance companies.

How much does Lexapro cost?

Your out-of-pocket costs for Lexapro and other medications can vary from one Medicare Prescription Drug Plan to another. You might have a deductible to pay before the plan begins paying a portion of your costs for Lexapro, and you usually have to make a copayment or coinsurance payment.

You may want to check the formulary, or covered drug list, of your Medicare Prescription Drug Plan or plans you’re looking into. Each Medicare Part D Prescription Drug Plan has a formulary that lists the prescription drugs they cover and states what your cost-sharing will be. Generic medications like escitalopram tend to be cheaper than brand-name ones like Lexapro, so you might want to ask your doctor if you can take the generic escitalopram instead of Lexapro.

Did you know that Medicare Part D Prescription Drug Plans may change their formularies?  The formulary may change at any time. You will receive notice from your plan when necessary.  You might want to check your plan’s Annual Notice of Change, which they’ll send you every fall, to make sure it still covers Lexapro and see if Lexapro costs have changed.

If you’re concerned about getting coverage for Lexapro and other prescription drugs, I can help you find plans available in your area that may cover Lexapro. Use one of the links below to set up a phone conversation with me, or to request an email with Medicare plan options for you. You can click the Find Plans or Compare Plans buttons on this page.

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