Ritalin (Methylphenidate) Prescription and Medicare Coverage

Ritalin is a medication that is usually prescribed to treat symptoms of narcolepsy and attention deficit/hyperactivity disorder (ADHD). It comes as an oral tablet, and you can purchase it in name brand or generic forms. Getting access to affordable drugs can be difficult without having an insurance plan that provides adequate coverage. 

Let's take a more detailed look at what Ritalin is and how you can find the right Medicare plan to take care of your prescription drug needs. 

What Does Ritalin Do?

Ritalin is a medication that acts as a stimulant to increase levels of dopamine and norepinephrine. The typical dosage is set at 20 mg, and how often you take it depends on what type of Ritalin you're prescribed. Ritalin Immediate Release (IR) usually requires two dosages per day while Ritalin Sustained Release (SR) only requires one dosage per day.

It's recommended to take the drug 30-45 minutes before eating a meal. If two doses a day are required, you should try taking it before 6 pm to avoid insomnia.

Due to the drug's high potential for misuse, abuse and addiction, Ritalin is categorized as a schedule II controlled substance. Improper use of the drug can potentially lead to severe physical or psychological dependence, which is why following dosage requirements and instructions from your doctor is important. 

Ritalin Side Effects

Ritalin comes with a few common side effects including:

• Dizziness
• Sleepiness
• Dry mouth
• Headache
• Upset stomach
• Loss of appetite
• Insomnia
• Nose and throat irritation

Ritalin has also been reported to cause heart problems in some people. Side effects of this may include an abnormal heartbeat, trouble speaking or thinking, shortness of breath, chest pain or pressure, weakness on one side of the body or fainting.

Changes in mood or behavior may also happen while taking Ritalin. You should reach out to your doctor if you experience hallucinations, depression, mood swings, changes in thinking or increased anger.

Does Medicare Cover Ritalin or Methylphenidate? 

Most Medicare plans don't cover the brand name form of Ritalin, but all Medicare Advantage plans that include drug benefits and Medicare Part D plans cover methylphenidate, the generic form. Medicare Advantage plans that offer coverage for prescription drugs are also referred to as Medicare Advantage Prescription Drug Plans (MA-PD). These plans come with their own drug list, or formulary, that provides information on which drugs are covered and how the plan covers them. 

How Much Does Ritalin Cost With Medicare Drug Coverage?

Your Medicare plan option and which coverage stage you're in are the deciding factors when it comes to the cost of your prescription drugs. There are two possible coverage stages that you can be in. 

Deductible Stage

While in the deductible stage, you're responsible for paying the full cost of your prescription. Your deductible is the amount of money you have to pay out-of-pocket for covered prescription drugs before your Medicare plan begins to cover the cost for you. Medicare drug plans can offer a deductible as low as $0. In 2024, Medicare drug plans cannot offer a deductible higher than $545.

Typically, you might pay $7 to $70 for Ritalin or Methylphenidate in the deductible stage. 

Copay Stage

You must meet your Part D deductible before you can enter the initial coverage period. After that, you may pay a copayment, which is a flat fee determined by your insurance plan, or a coinsurance, which is a set percentage of the total cost of your medication. 

A typical payment for Ritalin or Methylphenidate in this stage is between $3 and $69.

Additional Information About Ritalin

How Does Taking Ritalin Make You Feel?

Ritalin is meant to help you feel more focused and in control. Since it's a stimulant, the drug is meant to make you feel more alert, awake and talkative. These effects can be beneficial in helping you complete daily activities more efficiently and effectively.  

However, if you find that taking Ritalin is making you feel more irritable, aggressive or as if you're overstimulated, this should be brought up to your doctor. 

Does Ritalin Cause Weight Gain?

Stimulant drugs like Ritalin or Methylphenidate may cause weight loss instead. These drugs tend to make you less hungry and can cause your body to burn more calories than usual. Stimulant drugs are sometimes prescribed to treat binge eating or to help people lose weight. 

Is Ritalin Different From Adderall?

Ritalin and Adderall are different drugs in the sense that they contain different ingredients. Ritalin contains methylphenidate while Adderall is comprised of mixed amphetamine salts. However, they are both classified as stimulants and are meant to increase dopamine and norepinephrine in the brain, which is why either may be prescribed to treat ADHD. 

Ritalin has benefits and drawbacks like any other prescription drug on the market. By determining which Medicare plan best fits your needs, you may be able to find better coverage for your prescriptions. Reaching out to your doctor can help you decide whether Ritalin is the right medication for you.