Does Medicare Cover Glipizide?

Between 90% and 95% of the 37 million Americans with diabetes have type 2 diabetes. Many people can manage their condition with lifestyle changes, and several medications can prevent the risk of complications. If your doctor asks you to take glipizide, it can help to know if your Medicare policy covers the cost.

What Is Glipizide Used For?

Glipizide is a sulfonylurea medication that stimulates insulin production in the pancreas. Therefore, your doctor may prescribe this medication to prevent dangerously high blood sugar levels if you have type 2 diabetes. Glipizide isn't suitable if you have type 1 diabetes because it only works if the body can produce insulin.

This medication comes as tablets and extended-release tablets (glipizide ER.) It's available in generic versions or under the brand name Glucotrol. Your doctor may also recommend a medication called Metaglip, which contains a combination of glipizide and metformin.

Your doctor is likely to start you on a low dose of glipizide, and they may gradually increase the quantity until you see a satisfactory improvement in your blood sugar levels. They may recommend adopting healthy lifestyle changes to enhance the effectiveness of your treatment.

Glipizide Side Effects

Potential side effects include:

• Diarrhea
• Flatulence
• Itchy skin
• Rash, hives or blisters
• Dizziness 
• Shaking

Does Original Medicare Cover Glipizide?

Medicare doesn't cover glipizide if you're only enrolled in Parts A and B (Original Medicare.) Original Medicare usually excludes prescription medications, although it sometimes covers injectable drugs or medications delivered using durable medical equipment.

For example, Original Medicare may pay for your prescriptions if you take insulin using an insulin pump. However, it's highly unlikely to pay for medications you take at home, such as glipizide. 

Which Medicare Plans Cover Glipizide?

Fortunately, some Medicare plans purchased from private insurance companies cover glipizide. If you're an Original Medicare enrollee, you can add prescription medication benefits to your coverage by purchasing a Medicare Part D plan. All Medicare Part D plans cover glipizide, although they may not cover branded versions. They also cover generic glipizide ER.

Medicare Advantage plans are an alternative to Original Medicare. Insurance companies selling Medicare Advantage policies must offer the same coverage as Parts A and B at least, although most include enhanced benefits. Prescription drug coverage is one of the most common additional benefits. If your plan covers medications, it most likely covers glipizide. 

How Much Does Glipizide Cost With Medicare?

People with Original Medicare only must pay full price for their glipizide prescriptions. Most Part D and Medicare Advantage enrollees must also pay out of pocket until they spend enough to satisfy their deductible. Although some companies offer deductible-free prescription drug coverage, these plans are often expensive. 

Glipizide costs roughly $6 to $39 for 90 10-milligram tablets, but the costs vary widely depending on your location and the available pharmacies. It could be worth comparing the prices at several retailers to find the one with the most affordable glipizide cost. Some discount services also offer vouchers for glipizide, potentially reducing your out-of-pocket costs. 

Once you've met your deductible, your insurance company may provide free glipizide coverage. If your company requires co-pays, it's unlikely to charge more than $1.

Medicare Coverage Restrictions for Glipizide

Medicare Part D and Medicare Part A providers are unlikely to ask for your doctor's prior authorization before approving coverage for glipizide. However, expect your insurer to impose quantity limits on how many tablets you can receive at once.