Does Medicare Cover Timoptic?

Christian Worstell
In this article...
  • Timoptic is a type of eye drop used to reduce eye pressure in people with glaucoma. This guide explains whether Medicare covers Timoptic and other alternatives.

If you have glaucoma or another condition causing eye pressure, your doctor may prescribe Timoptic eye drops. Although Timoptic isn't the costliest medication, long-term use can become expensive. Therefore, it's worth checking whether your Medicare Part D plan covers Timoptic or similar drugs.

What Is Timoptic?

Timoptic is one of several branded medications containing timolol, which is a beta-blocker used to reduce eye pressure. It works by decreasing the amount of fluid inside the eye. 

The most common Timoptic dosage is a single drop in each affected eye twice daily. However, your doctor may recommend reducing your dose to one drop per day once you achieve a sustained reduction in eye pressure. 

Timoptic Side Effects

Timoptic isn't suitable for people with lung problems, asthma or certain heart conditions. It can cause a temporary burning or stinging sensation immediately after use. Other potential side effects include:

  • Eye redness
  • Eye pain
  • Excessive tear production
  • Headache 
  • Dizziness
  • Crusty eyes

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Does Medicare Cover Timoptic?

Timolol is covered by 97% of Medicare prescription drug coverage plans (Part D), but they won't necessarily cover the Timoptic brand. The easiest way to determine whether your plan covers Timoptic or an equivalent medication is to check the formulary, which is a comprehensive list of covered medications. You'll usually find timolol medications under Tier 4. 

If your plan doesn't cover Timoptic specifically, you could ask your doctor to prescribe generic timolol or a branded medication covered by your policy. Other branded medications containing timolol include Istalol and Betimol.

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

A 5-milliliter bottle of Timoptic costs around $206.49 without insurance, and you'll usually need to cover the cost yourself until you meet your deductible. Insurers can set their

Medicare Part D deductibles up to a maximum of $545. However, your insurance company may cover certain prescription medications before you satisfy your deductible. 

After paying the deductible, your insurer will pay most of the costs of your medication. Most Part D insurers charge a co-pay of between $4 and $41 for Timoptic prescriptions. 

Are There Any Medicare Coverage Restrictions for Timoptic?

Most plans covering Timoptic don't impose coverage restrictions. However, rules can vary, so it's wise to check your policy's terms to determine whether there's a prior authorization requirement or quantity restriction. 

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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