Does Medicare Cover Proventil?

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/12/2018

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Doctors might prescribe Proventil or the generic equivalent, albuterol, to treat wheezing, difficulty breathing, tightness in the chest, or certain other symptoms, according to the National Institutes of Health (NIH) National Library of Medicine. Original Medicare, which consists of Medicare Part A and B, only covers prescriptions in specific circumstances (as noted below). To get coverage for your Proventil, you may be able to sign up for a Medicare Part D Prescription Drug Plan that covers this medication.

What is Proventil?

Proventil may be available as a tablet, extended-release tablet, or as a syrup according to National Institutes of Health (NIH). Doctors might prescribe this drug to patients who suffer from breathing problems because of a respiratory illness, such as Chronic Obstructive Pulmonary Disease (COPD) or asthma, reports the NIH. Medical professionals classify this medicine as a bronchodilator. Proventil helps relax and open the airways to make breathing easier.

Will Medicare covers Proventil

It’s important to understand that Original Medicare, Part A and Part B, doesn’t cover most prescriptions:

  • Medicare Part A generally covers prescription medications like Proventil if they are given to patients as part of their treatment in the hospital or other inpatient facility.
  • Typical medications covered by Medicare Part B may include those that patients wouldn’t usually give themselves and are administered in outpatient settings.

If you receive a prescription for Proventil to take home, it most likely wouldn’t fall into these covered categories.

Medicare Prescription Drug Plans

You may be able to enroll in a stand-alone Medicare Part D Prescription Drug Plan. This plan can work alongside your Medicare Part A and Part B benefits.

Alternatively, you might choose to sign up for a Medicare Advantage Prescription Drug plan and also provides another way to get your Part A and B benefits (except hospice care, which Part A continues to cover).Many Medicare Advantage plans come with additional benefits, such as routine dental or vision care. With a Medicare Advantage Plan you will have to continue to pay your Part B premium, besides any premium the plan may charge.

The formulary, or covered prescription drug list, of either of these plan types will tell you whether the plan covers Proventil or albuterol. Note that plans can change their formularies, but they must notify plan members in advance of any changes.

How to find a Medicare plan option that may cover Proventil

If you’d like to find a Medicare plan option to cover Proventil or other prescription medicine, I am here to assist you:

  • You are welcome to request a call or informational email by clicking the button below.
  • To research local Medicare plan options at your leisure, click on the “Compare Plans” button.

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