Does Medicare Cover Cimetidine?

Available in prescription strength and over-the-counter versions, cimetidine treats heartburn, reflux disease and conditions that result in above-average levels of acid in the stomach. If taken long-term, cimetidine can result in ongoing out-of-pocket costs for older adults. 

Medicare Coverage for Cimetidine 

The majority of Medicare plans provide coverage for cimetidine prescriptions. According to GoodRx.com, about 59% of Medicare plans cover cimetidine in tablet form and 61% of plans cover cimetidine in oral solution. A cimetidine prescription will usually result in a lower out-of-pocket cost when compared to Tagamet, the brand alternative. 

Basic Drug Information for Cimetidine 

Cimetidine, the generic form of Tagamet, works by decreasing the amount of acid produced in the stomach. It belongs to the H2 blocker class of medications and may be prescribed to treat ulcers, gastroesophageal reflux disease (GERD) and heartburn. This drug may be administered orally via tablet or liquid suspension. It's usually taken at least twice a day or according to the prescriber's directions. The most common side effects of cimetidine include headache, diarrhea, dizziness and drowsiness. It's important to contact the prescriber if these side effects become severe or do not go away. 

How Much Does Cimetidine Cost With Medicare? 

The cost of cimetidine with Medicare coverage differs based on your location, plan type and drug coverage stage. Once you have reached the initial coverage stage with your drug plan, you can expect to pay anywhere from $0-$43, on average, for cimetidine. Individuals who are dually enrolled in Medicaid or receive other prescription drug assistance will pay less for a 30- or 90-day prescription. 

What Is the Deductible for Medicare Part D in 2024? 

It's important to consider that the cost of cimetidine depends on which drug coverage stage you are currently in. In the deductible stage, you will likely pay the full cost of the drug until your deductible is met. In 2024, the maximum deductible amount is $545; this was increased from $505 in 2023. Some enrollees may qualify for Extra Help with prescription drug costs through the Social Security Administration, which can lower or eliminate the annual Part D deductible. 

Does Medicare Cover Cimetidine Purchased Over-the-Counter? 

In addition to the prescription strength formulation, cimetidine is available for purchase as an over-the-counter (OTC) drug. Medicare Part D coverage does not help reduce the cost of OTC drugs. However, some Medicare Advantage plans may offer enhanced OTC benefits, typically through a plan vendor. Beneficiaries should check with their insurance plan and their doctor to determine if cimetidine is available at the recommended strength using OTC benefits.