Does Medicare Cover Lotensin?

Tamera Jackson by Tamera Jackson | Licensed since 2007
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This article was updated on: 09/10/2018

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Lotensin is used to treat high blood pressure; it is sometimes used with other prescription medications as combination therapy for certain types of hypertension (high blood pressure), according to the National Institutes of Health (NIH). Lowering blood pressure may reduce the risk of stroke and heart attack. In most cases, Medicare does not cover treatment with Lotensin, but you may be able to sign up for prescription drug coverage under Medicare Part D.

When might Medicare cover Lotensin?

According the FDA, patients with high blood pressure may require more than one prescription drug, like Lotensin, to reach blood pressure goals. As well as taking medications your doctor prescribes for you, you may want to discuss healthy lifestyle choices for cardiovascular risk management with your doctor. These choices may include  exercise, quitting smoking, cutting down on salt, and losing weight, according to the National Institutes of Health (NIH).

Lotensin is in a class of medications known as ACE inhibitors, which work by relaxing the blood vessels, making it easier for the heart to pump blood through the body, the NIH reports. Like most prescription drugs you take at home, Original Medicare (Part A and Part B) doesn’t generally cover Lotensin, unless you receive it while an inpatient in a hospital or nursing home during a covered stay, as part of your treatment.

However, if you enroll in prescription drug coverage under Medicare Part D, your plan may pay for your Lotensin, or its generic equivalent, benazepril. Medicare Prescription Drug Plans are offered by private insurance companies approved by Medicare; each plan uses a formulary, or list of covered medications and the benefits available for each.

Individual insurance companies develop their own plan formularies in accordance with Medicare guidelines, which state that plans must cover a range of available prescription medications to treat most illnesses and diseases. Plans may change their formularies at any time, but they are required to notify you in writing before they do. If you take Lotensin and your plan discontinues it, you’ll know in advance so your doctor can prescribe a similar medication that may be covered by your plan.

You can find out if your plan covers Lotensin by checking the formulary; most plans publish theirs online. If you haven’t enrolled in Medicare prescription drug coverage yet, you can search for plans that may cover Lotensin in your vicinity. Just enter your zip code in the box on this page to get started.

How can I enroll in Medicare Part D coverage for prescription drugs such as Lotensin?

Medicare Part D prescription drug coverage is available in two ways:

  • As a stand-alone plan to complement your coverage under Original Medicare.
  • As part of a Medicare Advantage Prescription Drug plan, sometimes called MAPDs.

Although enrollment in prescription drug coverage is voluntary, it’s a good idea to enroll as soon as you are eligible if you think you’ll eventually want the coverage. This is because you may have to pay a late-enrollment penalty with your monthly premium for as long as you have coverage if you wait. You can usually avoid this penalty, however, if you already have equivalent prescription drug coverage through another source such as an employer plan.

You can enroll in a Medicare Part D Prescription Drug Plan as soon as you become eligible to enroll in Medicare. You can also enroll during the Annual Election Period. You must be enrolled in Part A and/or Part B to get a stand-alone Medicare Part D Prescription Drug Plan, and you must live within the plan’s service area.

Medicare Advantage plans are required to cover everything included in Original Medicare, (except hospice care, which is still covered under Part A) but they may also offer additional benefits that help people with hypertension, such as prescription drug coverage. A Medicare Advantage plan may also cover wellness programs, discounted gym memberships, routine vision, dental, and hearing care. With a Medicare Advantage plan, you will have to continue paying your Part B premium.

Not all Medicare Advantage and stand-alone Medicare Part D Prescription Drug Plans are available in all areas, and plan premiums, deductibles, and benefits may vary depending on the plan you choose and where you live.

If you’d like more information about Medicare coverage for Lotensin, or the Medicare plan options available in your area, I’m here to help. You can request information via email or schedule a phone call at your convenience by clicking one of the links. To see a list of plans in your area that you may qualify for, click the Compare Plans or Find Plans buttons.

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