Does Medicare Cover Digox?

Digox is an essential drug for many people with congestive heart failure, and it's also relatively affordable. However, the costs of taking Digox can add up over an extended period, so it's worth checking if your healthcare insurance can help. Read on to discover if Medicare covers Digox.

What Is Digox?

Digox is a branded version of digoxin, a medication used to treat congestive heart failure and atrial fibrillation. It works by improving the heart's efficiency and regulating the heartbeat to reduce swelling and promote blood circulation. 

Generic digoxin is available in tablet or solution form, but Digox is a film-coated tablet. Doctors generally prescribe Digox alongside diuretics and ACE inhibitors for people with congestive heart failure. 

This drug is most effective when you maintain steady levels, so you should take it at the same time every day — even if you're not experiencing symptoms. Doctors determine the correct dose depending on your condition and body weight, usually prescribing between 3 and 4.5 micrograms per kilogram.

Digox Side Effects

Stopping your medication can cause a severe deterioration in your condition, so it's essential to consult with your doctor if you want to change your treatment plan. Potential side effects of Digox include:

• Dizziness and fainting
• Rapid, slow or irregular heartbeat
• Bloody vomit, urine or stools
• Rash
• Stomach pain
• Bleeding gums

Does Medicare Cover Digox?

Medicare Parts A and B don't cover Digox. However, you may be eligible for coverage if you have a supplemental prescription medication plan (Part D). Digoxin is covered by 100% of Medicare Part D policies, but they may not cover the Digox brand specifically.

You'll find Digox under Tier 2 of your plan's formulary if your insurer covers it. If your policy excludes Digox, your doctor may choose to prescribe generic digoxin or an alternative branded version included in your plan.

How Much Will I Pay for Digox With Medicare Part D?

Most Medicare Part D plans include deductibles up to $545, although some insurers offer zero-deductible products. Part D plans without deductibles often have higher monthly premiums than plans with higher deductibles. 

You're liable to cover the cost of Digox up to your deductible amount. Digox costs around $27.37 for a box of 30 125-microgram tablets. After that, you'll enter the post-deductible phase when your insurer pays for your medication. 

Co-pays for Digox prescriptions are relatively low because it's an inexpensive medication, and many insurance companies don't charge co-pays for drugs at this price point. However, other insurers may charge around $1 per prescription. 

Does Medicare Restrict Digox Coverage?

You won't usually require prior authorization for Digox coverage through Medicare. However, your insurance company may limit how much medication your pharmacy can fill per prescription.