Does Medicare Cover Percocet?

Mike Olmos by Mike Olmos | Licensed since 2010
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This article was updated on: 09/10/2018

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What is Percocet?

Percocet (generic name acetaminophen and oxycodone) is a prescription pain reliever. One ingredient in Percocet, acetaminophen, is an active ingredient in many over-the-counter medicines according to the Food and Drug Administration (FDA). The other ingredient in Percocet, oxycodone, is an opiate (narcotic) and is usually available only by prescription. According to the FDA, Percocet  may be used to treat moderate to severe pain and may be covered under a Medicare Part D prescription drug plan. Percocet may be habit-forming and should only be used as directed by your doctor.

Does Original Medicare cover Percocet?

If you’re a Medicare beneficiary with Original Medicare (Part A and Part B), keep in mind that prescription drug coverage for Percocet and other drugs is limited. You’ll be covered under Medicare Part A for most prescription drugs that you get as part of a covered inpatient stay in a hospital or skilled nursing facility. If you’re given Percocet to manage pain while in the hospital, Medicare Part A will usually cover it. Medicare Part B covers some drugs that you get in an outpatient setting, like a doctor’s office. These types of drugs are usually medications that are administered to you like infusions and injections, not prescriptions you take orally like Percocet.

Does Medicare Part D cover Percocet?

For most prescription drug coverage for prescription drugs such as Percocet, you can enroll in a Medicare Part D Prescription Drug plan. You can get a stand-alone Medicare Part D Prescription Drug Plan to add to your Original Medicare coverage, or you can get all your Medicare coverage through a Medicare Advantage Prescription Drug plan (MAPD). Either type of Medicare Part D coverage may cover Percocet, but you’ll need to check the plan’s drug formulary, which is a list of all the drugs that are covered by that plan. Formularies may vary by plan and can change from year to year.* Always take the time to review your current coverage to make sure your plan still covers all the prescription drugs that you’re taking including Percocet.

Just as drug formularies can change every year, costs may change as well. Different Medicare plans may have higher or lower costs to cover the same medications. Brand-name drugs will usually cost more than generics. Ask your doctor if you need to take brand-name Percocet or if the generic acetaminophen/oxycodone will work for you.

Do you have more questions about Medicare coverage of Percocet?

As you can tell, there are many factors to consider when finding a Medicare Part D Prescription Drug plan that covers your medications such as Percocet. If you have any questions, that’s what I’m here for. To have me help you by phone or through email, just use the links below: we can set up a time to talk, or I can email you some of your Medicare Part D Prescription Drug options. If you’d like to view plans right away, just use the Compare Plans buttons on this page to begin comparing coverage options in your area.

*The formulary may change at any time. You will receive notice from your plan when necessary.

 

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