Does Medicare Cover Plavix?

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

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Plavix (Plavix generic:Clopidogrel) is used in the treatment of heart health. Plavix may be prescribed by your doctor or health-care provider to prevent a heart attack or stroke, according to the FDA. Plavix is in a class of medications called antiplatelet medications that works by preventing platelets from collecting and forming clots. Plavix comes as a tablet taken by mouth.

Does Medicare Part A cover Plavix?

Medicare Part A may cover Plavix if you take it as an inpatient in a hospital or skilled nursing facility. However, if you take Plavix at home, Medicare Part A generally will not cover it.

Does Medicare Part B cover Plavix?

There are only certain types of prescription medications covered under Original Medicare Part B, and most of them are generally limited to medications administered at a doctor’s office or in a hospital outpatient setting. For “at home” medications, like Plavix it’s likely that you’re going to need prescription drug coverage through Medicare Part D.

Does Medicare Part D cover Plavix?

You can get Part D coverage for Plavix in one of two ways: through a stand-alone Medicare Part D Prescription Drug Plan added to your Original Medicare, or through a Medicare Advantage Prescription Drug plan, which offers the same benefits as Original Medicare, but includes drug coverage.

To see what medications are covered and how much they could cost, you’ll want to check Medicare Part D prescription drug plan’s formulary, or drug list. You may find that brand-name drugs tend to cost more than generic drugs, so ask your doctor if the prescriptions you need, such as Plavix have a generic option. A Medicare drug plan’s formulary may change at any time. If this happens, you will receive notice from your plan.  Additionally, the formulary may change every year, meaning that the medications you take may no longer be covered or may be subject to prior authorization rules and your cost-sharing could increase or decrease accordingly. Be sure to review your medication needs each year against your plan’s formulary to verify your medication expenses are affordable for you.

Do you need help finding Medicare coverage for Plavix?

You may find yourself in the market for a new Medicare Prescription Drug Plan to cover Plavix. Or maybe you’re in the process of joining a prescription drug plan for the first time and would like some help. I can help! Use the links below to set up a phone call with me or have me email you Medicare plan options. If you want to start comparing Medicare plans yourself, use the Compare Plans buttons on this page.

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