Does Medicare Cover Pravachol?

Last Updated : 09/10/20183 min read

You might receive a prescription for a medicine called Pravachol from your doctor. This is the brand name for a generic prescription drug pravastatin, used to reduce to the risk of heart attack and stroke, according to the National Institute of Health (NIH) National Library of Medicine.

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Original Medicare doesn’t cover either generic or brand-name prescriptions, except in certain limited situations. To get coverage for Pravachol or pravastatin, you might want to sign up for a stand-alone Medicare Part D Prescription Drug Plan.

As another option, you might consider enrolling in one of the many Medicare Advantage Prescription Drug plans. Learn more about Pravachol and about Medicare prescription drug coverage below.

What is Pravachol?

NIH states that doctors prescribe Pravachol for patients who either have heart disease or at risk of developing heart disease. Patients use this medicine combined with weight loss, exercise, and diet in order to reduce the risk of suffering from a stroke or heart attack. Doctors classify this medicine as a HMG-CoA reductase inhibitor or statin. Pravachol comes in the form of a tablet, usually prescribed for patients to take once a day.

How Medicare might cover prescription drugs

Original Medicare Part A or B won’t usually cover a Pravachol prescription. Part A only helps pay for prescriptions that people receive as a part of their inpatient medical treatment. Part B may cover a limited set of prescription medications that outpatients receive in certain clinics, and these aren’t usually oral medications that patients take themselves.

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To receive coverage for your Pravachol, pravastatin, or another statin drug prescription, you might need to enroll in a stand-alone Medicare Part D Prescription Drug Plan. Or you may consider enrolling in a Medicare Advantage Prescription Drug plan instead. Medicare Advantage plans provide an alternative way to get the benefits provided by Part A and Part B from a Medicare-approved plan offered by a private insurance company. With a Medicare Advantage plan, your hospice care will still be covered under Part A, and you will still have to pay your Part B premium along with any plan premium.

With either option, your plan will have a list of covered prescription drugs, called a formulary. This list tells you how the plan covers different prescriptions. Insurance companies might change their formularies from time to time, but you will be notified when necessary.

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Would you like some help finding coverage for Prevachol or other kinds of prescription drugs? If you need help, I’m here to offer it:

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