Does Medicare Cover Prevacid?

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 09/12/2018

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Doctors may prescribe Prevacid, or the equivalent generic lansoprazole, to treat gastroesophageal reflux disease (GERD) and help prevent ulcers, according to the National Institutes of Health (NIH) National Library of Medicine. You can also buy an over-the-counter version of this medicine to treat heartburn. Original Medicare doesn’t typically cover prescription drugs except in certain situations listed below, but a Medicare Prescription Drug Plan might offer this coverage.

What is Prevacid?

Doctors might prescribe Prevacid to treat gastroesophageal reflux disease (also called GERD) which, according to the Mayo Clinic, is closely related to acid reflux. This condition causes stomach acid to flow back out of the esophagus and cause a burning sensation and damage. According to NIH, Prevacid helps prevent this condition and gives the esophagus time to heal.

Pharmacologists classify Prevacid as a proton pump inhibitor, the NIH reports. It works because it helps decrease the amount of stomach acid made by the body.

Will Medicare cover Prevacid?

Typically, neither the prescription nor the over-the-counter version of this medication will be covered by Medicare. These are some instances when Original Medicare may cover prescription drugs:

  • Medicare Part A may covers prescriptions that patients get as part of their inpatient treatment while in a hospital or similar setting.
  • Medicare Part B may cover some prescription medications that doctors or other providers directly administer in certain outpatient settings.

Do you plan to fill your Prevacid (or lansoprazole) prescription at a pharmacy? You might get your prescription covered by a stand-alone Medicare Part D Prescription Drug Plan. Or, instead, you might enroll in a Medicare Advantage Prescription Drug plan. Medicare Advantage plans offer a way for beneficiaries to get their Medicare Part A and Part B benefits through a private, Medicare-approved insurance company instead of directly through the government. With a Medicare Advantage plan you will have to continue to pay your Part B premium.  Part A still covers hospice benefits even when you’re enrolled in a Medicare Advantage plan.

Either plan type will have a formulary, or list of covered prescription drugs. The insurance company can change its formulary, but will notify plan members when necessary.

How to find Medicare plan options to cover Prevacid

If you need to fill prescriptions for Prevacid, you may be able to find a Medicare plan option that will help cover your medication costs. If you would like help, I’m here to assist you:

  • You may schedule a call or request a personal email by clicking one of the buttons below.
  • To learn more about different Medicare plan options in your area, click the “Compare Plans” button.

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