Does Medicare Cover Hyzaar?
This article was updated on: 09/12/2018
Hyzaar is used to treat high blood pressure (hypertension) and reduce the risk of stroke, according to the U.S. National Library of Medicine. In most cases, Medicare does not cover Hyzaar, unless you have stand-alone Medicare Part D prescription drug coverage or a Medicare Advantage Prescription Drug plan. If you take Hyzaar, here’s what you should know about Medicare Part D coverage for prescription drugs and how to get it.
When does Medicare cover Hyzaar?
The Medicare program has four parts: Part A, or hospital insurance, and Part B, medical insurance (called Original Medicare), Part C (also known as Medicare Advantage), and Part D (coverage for prescription drugs). Under Original Medicare, there is generally no coverage for Hyzaar, unless you receive it as an inpatient in a hospital or nursing home during a covered inpatient admission.
Hyzaar is the brand-name combination preparation of the generic drugs losartan and hydrochlorothiazide, according to the National Institutes of Health. It may be covered under a Medicare Prescription Drug Plan. You can find out by checking your plan’s formulary, which is usually published online. A formulary is simply a list of covered medications and the benefits allowed for each; each plan develops its own formulary according to Medicare guidelines. Plans may change their formularies from time to time, but if you’re a member, you’ll get written notice when necessary.
All Medicare Part D prescription drug coverage must include a wide range of commonly prescribed medications like Hyzaar to treat common illnesses and conditions. If your plan doesn’t pay for Hyzaar, or it drops coverage later on, your doctor may be able to find a similarly effective medication in your plan’s formulary to treat your high blood pressure.
How do I get Medicare Part D prescription drug coverage for Hyzaar?
Medicare Part D coverage for prescription drugs such as Hyzaar is available in two ways:
- You can enroll in a stand-alone prescription drug plan (Part D) to complement your Original Medicare and certain other types of Medicare health plans, or
- You can select a Medicare Advantage plan in your area that includes coverage for prescription drugs.
Some people with hypertension find that a Medicare Advantage plan with prescription drug coverage meets their health-care needs, because it offers an alternative way to get all your Medicare benefits in one convenient plan. Medicare Advantage plans are required to cover everything included in Original Medicare (except hospice care, which is still covered under Part A), but they may also offer additional benefits that help people with hypertension, such as:
- Coverage for wellness programs
- Discounted gym memberships
- Routine vision, dental, and hearing care coverage
It’s important to remember that all Medicare Part D Prescription Drug Plans and Medicare Advantage plans are offered by private insurance companies contracted with Medicare to provide these benefits and not all plans and benefits may be available in your service area. In addition, your premiums, deductibles, copayments, and coinsurance amounts may differ depending on the plan you select and where you live. You must continue to pay your Part B premium, plus any additional premiums required by your plan, if you enroll in Medicare Advantage.
If you need help understanding your options for Medicare coverage of Hyzaar and your treatment for hypertension, I’m available to answer your questions. To see a list of plans in your area that you may qualify for, click the Compare Plans or Find Plans buttons.