Does Medicare Cover Fenofibrate?

Fenofibrate isn't the most expensive medication out there, but the costs can become significant if you take it long-term. Therefore, you may be wondering if Medicare covers your prescriptions. Let's explore whether Medicare covers fenofibrate, including how much you should expect to spend on co-pays.

What Is Fenofibrate?

Fenofibrate reduces the amount of cholesterol, triglycerides and high-density lipoproteins (HDLs) in your blood. Combining this medication with healthy lifestyle changes can reduce the risk of developing pancreatitis. Your doctor may prescribe fenofibrate if blood tests show you have high cholesterol or hypertriglyceridemia. 

There are various fenofibrate brands, including:

• Fenoglide
• Lipofen
• Tricor
• Triglide

Most people take one fenofibrate dose per day. However, your doctor will tailor your dosage according to factors such as your age, blood test results and body composition. 

Fenofibrate can occasionally cause liver problems, skin reactions and gallstones. It could also make you more prone to developing certain infections. Contact your doctor immediately if you experience serious side effects, including hives, yellow skin or eyes or unusual bruising.

Does Medicare Cover Fenofibrate?

It's unlikely that Original Medicare (Parts A and B) will cover fenofibrate, as it only covers doctor-administered drugs in very limited circumstances. However, you may be eligible for coverage if you have a Medicare Part D (prescription drug coverage plan.)

According to GoodRx, 100% of Medicare Part D providers cover fenofibrate, although brand coverage may vary by provider. For example, some insurers may cover generic fenofibrate only.

How Much Will I Pay for Fenofibrate With Medicare?

How much you'll pay for fenofibrate with Medicare varies widely because it depends on your annual deductible. Medicare-approved insurers are free to set their own Part D deductibles, providing they don't exceed the $545 legal maximum. While zero-deductible plans are available, they're usually significantly more expensive than plans with deductibles. 

Enrollees are responsible for paying for their medication until they meet their provider's deductible requirements. You should expect to pay around $51.60 for 30 160-milligram tablets, although prices from individual pharmacies may vary. 

Your insurer assumes responsibility for paying your medication costs once you pay your deductible. Some companies don't charge co-pays for covering fenofibrate prescriptions. Others may require a nominal co-pay, which is unlikely to exceed around $2. 

Fenofibrate With Medicare: Do Restrictions Apply?

Medicare coverage restrictions for fenofibrate prescriptions are relatively unusual. However, some insurers set quantity restrictions or require a doctor's authorization, so it's worth checking your plan's terms.