Does Medicare Cover Protonix?

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 Protonix?

Protonix or its generic form Pantoprazole may be prescribed to treat acid reflux or other stomach or esophagus problems. According to the FDA, Protonix is part of a class of drugs called proton pump inhibitors.

Does Medicare Part A cover Protonix?

Medicare Part A generally covers prescription drugs you receive in an inpatient setting, such as the hospital. If you take Protonix during a covered inpatient stay, Medicare Part A will typically cover it.

Does Medicare Part B cover Protonix?

Very few prescription medications are covered under Medicare Part B, and these are usually limited to drugs given at a doctor’s office or in a hospital outpatient setting, not prescription drugs you take at home like Protonix. For prescription medications such as Protonix, you may need drug coverage through Medicare Part D. You can get this through either a stand-alone Prescription Drug Plan which may cover Protonix or a Medicare Advantage Prescription Drug plan, which offers the same benefits as Original Medicare and includes prescription drug coverage for drugs such as Protonix.

To find out what medications are covered and how much they will cost, you’ll want to look at the Medicare Prescription Drug Plan’s formulary, or drug list. You may see that brand-name drugs tend to cost more than generic drugs, so check with your doctor and ask if you need Protonix or Pantoprazole. Keep in mind that a Medicare Prescription Drug Plan’s formulary may change at any time. You will receive notice from your plan when necessary. Additionally, the formulary might change every year, so what the plan used to cover or charge for a drug one year could be different the following year.

Do you need help finding Medicare coverage for Protonix?

I can help you compare Medicare Prescription Drug Plans or change the plan you currently have to one that covers Protonix. Let me help you find what’s available in your service area. You can set up a phone call with me or have me email you Medicare plan options by clicking one of the links below. If you want to compare Medicare plans by yourself, use the Compare Plans buttons on this page.

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