Does Medicare Cover Morphine

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/10/2018

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What is Morphine?

Morphine is a prescription drug used to relieve moderate to severe pain, according to the U.S. National Library of Medicine. Morphine is narcotic (opiate) that works by changing the way the brain and the nervous system respond to pain. Other narcotics according to the Drug Enforcement Administration are: Oxycontin, Vicodin, Codeine, and Fentanyl. Liquid morphine can be taken every 4 hours as needed for pain. Extended-release (long acting) morphine can be taken every 8 to 24 hours, depending on the brand, according to the U.S. National Library of Medicine. Brands of morphine include Kadian, Arymo, and Morphabond. Your doctor may start you on a low dose of morphine and increase it until your pain is under control. Morphine may cause life-threatening breathing problems, so call your doctor immediately if you experience slowed breathing or shortness of breath, advises the U.S. National Library of Medicine.

Does Original Medicare (Part A and Part B) cover Morphine?

Original Medicare (Part A and Part B) offers limited coverage of prescription drugs like morphine. Medicare Part B may cover drugs you wouldn’t usually give to yourself, like drugs you get at a doctor’s office or hospital outpatient setting. Prescription drugs covered by Part B are generally given by infusion or injection, and not generally prescription drugs you take by mouth at home, like morphine.

If you are an inpatient in a hospital, Medicare Part A will typically cover prescription drugs you receive as inpatient treatment. For example, if you are in the hospital recovering from a surgery and your doctor prescribes morphine, Medicare Part A will generally cover morphine for your hospital stay. If you continue to take morphine while recovering at home, Medicare Part A will generally not cover it.

Do other parts of Medicare cover Morphine?

You can get prescription drug coverage for morphine you take at home through:

  • A stand-alone Part D Prescription Drug Plan
  • A Medicare Advantage plan with prescription drug coverage

Both types of plans are offered through Medicare-approved private insurance companies. A stand-alone Part D Prescription Drug Plan works alongside your Original Medicare coverage. A Medicare Advantage plan with prescription drug coverage covers everything Original Medicare covers (with the exception of hospice care which Part A still covers) as well as prescription drugs such as morphine.

To find out if your plan covers morphine, check the plan’s formulary, which is a list of the prescription medications covered by the plan. The formulary may change at any time. You will receive notice from your plan when necessary. Formularies vary by plan and may change every year, so it’s important to review your coverage annually.

Keep in mind that costs for covered drugs are determined by each Medicare Part D Prescription Drug plan. Medications in the plan’s formulary are usually placed into tiers, with different copayment and coinsurance costs for the drugs on each tier. You may have lower costs if you take a generic medication such as morphine instead of a brand-name drug, such as Kadian, Arymo, and Morphabond.

If you want help finding Medicare Part D Prescription Drug plans that cover morphine, I’d be glad to help. Use the links below to set up a time for us to talk by phone, or I can email you some possible plan options. Our Compare Plans buttons are available, too, if you’d like to begin searching for plans now.

This article provides general information, and is not a substitute for medical advice.  Only a licensed medical professional can diagnose and treat medical conditions.

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