Effexor (Venlafaxine) Medicare Coverage

Effexor
Chemical name: Venlafaxine Brand name: Effexor Typical dosage: 75mg Typical type: Tablet¹ Effexor is a medication used to treat multiple mood disorders such as severe anxiety and depression. Effexor is available as a brand name or generic drug and comes as an oral tablet and oral capsule.

Effexor is a medication that contains the active ingredient Venlafaxine. Effexor is used to treat a variety of disorders including generalized anxiety disorder, major depressive disorder, panic disorder and social anxiety disorder.

Effexor is typically taken 1-3 times daily, depending on what type of symptoms are being treated. Effexor comes in a long-acting or short-acting formulation.

Common side effects of Effexor include insomnia, exitability, weight loss, loss of appetite, fatigue, dizziness, shakiness, headache, sweating, upset stomach, constipation, gas, dry mouth and strange dreams.

Does Medicare cover Effexor or Venlafaxine?

While some Medicare plans may not cover Effexor, some Medicare Advantage plans and Medicare Part D plans may cover Venlafaxine.

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 Venlafaxine.

Find Medicare Advantage plans with drug coverage

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Or call 1-800-557-6059 1-800-557-6059 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 Venlafaxine 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

Effexor can increase the chance of suicidal thoughts or actions in young adults. Follow up with your doctor closely and talk to them if you experience signs of worsening depression or anxiety, or if you have any suicidal thoughts.

Take your Effexor dose with food, at the same time of day every day.

Continue taking Effexor even if you don’t notice a difference, or if you start to feel better. You may have to take Effexor for a few weeks to start feeling the effects.

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.