Ceftriaxone (Rocephin) Medicare Coverage

Ceftriaxone
Chemical name: Ceftriaxone

Brand name: Rocephin

Typical dosage: 1g

Typical type: Injection1

Ceftriaxone is an antibiotic used to treat many different types of infections. It is available as a generic medication and comes as an injection.

Ceftriaxone is an antibiotic medication used to treat infections including bloodstream infections, bone and joint infections, abdominal infections, brain infections, lung infections and more. The brand name equivalent of Ceftriaxone is called Rocephin.

Ceftriaxone works by inhibiting bacterial cell walls so infections can’t spread farther in the body. Ceftriaxone is given as an injection into a vein or muscle and can be used for up to 6 weeks or longer, depending on the type of infection you have.

Side effects common with Ceftriaxone include diarrhea and upset stomach. Some patients also experience irritation where the injection is given.

Does Medicare cover Ceftriaxone or Rocephin?

Some Medicare Advantage plans and Medicare Part D plans may cover Ceftriaxone.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Ceftriaxone.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Ceftriaxone with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Ceftriaxone should only be given as an injection into the vein or into the muscle.

Let your doctor know if you experience pancreas symptoms, gallstone symptoms or kidney symptoms after taking Ceftriaxone.

  • Signs of pancreas problems include stomach pain, back pain, upset stomach or vomiting.

  • Gallstone symptoms may include pain in the abdomen, pain in the shoulder or between the shoulder blades, yellow skin or eyes or fever with chills.

  • Signs of kidney problems may include changes in passing urine, pain while passing urine, weight gain or blood in the urine.

Anemia can happen while taking Ceftriaxone. Watch for signs of pale skin, dizziness, fever, chills, back or stomach pain or if you feel tired or weak.

Let your doctor know if diarrhea persists or if it becomes very severe.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.