Cymbalta (Duloxetine) Medicare Coverage

Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI) medication. The generic equivalent of Cymbalta is called Duloxetine.

Cymbalta is typically used to treat anxiety, depression, chronic pain due to fibromyalgia and nerve pain associated with diabetes.

Cymbalta increases serotonin and norepinephrine in the brain. These neurotransmitters are key in regulating mood. It is taken once daily, and your doctor-recommended dosage will typically depend on what symptoms you are treating and how well you react to the medication.

Side effects of Cymbalta may include difficulty sleeping, drowsiness, excessive sweating, weight loss, upset stomach and decreased appetite.

How much does Duloxetine cost with Medicare?

Duloxetine coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Duloxetine?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Duloxetine, the generic form of Cymbalta, in 2023.¹

• Medicare Advantage plans or Part D plans that cover Duloxetine include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• 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 Duloxetine. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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.

Additional information

It may take a few weeks for you to feel the effects of Cymbalta. Don’t stop taking Cymbalta all of a sudden. Doing this can lead to withdrawal and increased side effects. Talk to your doctor if you decide you no longer want to take Cymbalta.

You may experience increased bleeding while on Cymbalta, especially if you take it with medications like blood thinners or NSAIDs and aspirin. Be aware of any signs of abnormal bleeding and report them to your doctor.

Liver problems can occur while taking Cymbalta. Call your doctor if you experience stomach pain, severe nausea or yellow skin or eyes.

Cymbalta can increase the risk of suicidal thoughts. Call your doctor if you experience such thoughts or drastic changes in mood.

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.