Does Medicare Cover Zocor?

Jory Cross by Jory Cross | Licensed since 2012

This article was updated on: 09/12/2018

Zocor is a medication called a “statin” that some patients use to lower their levels of certain kinds of cholesterol, per the United States Food and Drug Administration. If you are enrolled in Medicare, you may have coverage for Zocor and its generic, simvastatin, if you have a Medicare-approved Prescription Drug plan that covers Zocor and simvastatin.

Which parts of Medicare offer potential coverage for Zocor?

Medicare is a government insurance program for people over 65 and other eligible applicants. Medicare offers coverage in four separate parts, some which can be combined:

  • Medicare Part A: Hospital coverage, as well as hospice, skilled nursing care and nursing home care
  • Medicare Part B: Medical insurance, including visits to doctors, preventive health care, and durable medical equipment
  • Medicare Part C: Medicare approved coverage from a Medicare Advantage plan
  • Medicare Part D: Prescription drug coverage, which may include Zocor

Medicare Part A and Part B are often referred to as “Original Medicare.” They typically do not cover prescription drugs that you administer yourself at home. You may also elect Medicare coverage through a Medicare-approved private insurance company with a Medicare Advantage plan. A Medicare Advantage plan (Medicare Part C) provides similar coverage to Original Medicare, but doesn’t cover hospice care, which Part A still covers. Medicare Advantage plans may also offer coverage for prescription drugs, depending on the plan you choose.

How does Medicare cover Zocor?

If you want prescription drug coverage for Zocor, you generally must opt for a Medicare Part D standalone prescription drug coverage plan that covers Zocor, or enroll in a Medicare Advantage plan that also insures prescription drugs and includes Zocor in its formulary, or list of covered prescription drugs.

In order to enroll in a Medicare Part D Prescription Drug Plan as a stand-alone insurance plan, you generally must be 65 years old or have a disability and be enrolled in Medicare Part A or Medicare Part B. After your 7-month initial enrollment period, Part D enrollment occurs twice a year, and you may be charged a fee for late enrollment. The formulary for the plan you choose may change at any point, you’ll be notified in writing before any changes take effect.

When does Medicare cover Zocor?

Your doctor may prescribe Zocor to you to treat your levels of low-density lipoprotein (LDL) cholesterol. To see if your Medicare Prescription Drug Plan covers Zocor, you must read the most updated version of your plan formulary. Next, confirm that the pharmacy where you plan to obtain the prescription is also Medicare-approved and within your plan network.

If you are ready to learn more about your Medicare plan options and Medicare coverage for Zocor, I am happy to help.

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