Mycophenolate (Cellcept) Medicare Coverage

Mycophenolate
Chemical name: Mycophenolate

Brand name: Cellcept

Typical dosage: 500mg

Typical type: Tablet1

Mycophenolate is a medication used in organ transplantation. Mycophenolate is available as a brand name drug or generic and comes as an oral capsule, an oral liquid and an oral tablet.

Mycophenolate is a medication used to prevent rejection of an organ transplant in patients who receive a kidney transplant, heart transplant or liver transplant. Mycophenolate intentionally weakens the immune system to prevent it from attacking the transplanted organs.

The brand name equivalent of Mycophenolate is called Cellcept. It is typically taken twice daily.

Common side effects of Mycophenolate include back pain, constipation, headache, dizziness, loss of appetite, diarreha, gas, fatigue, upset stomach, insomnia and joint pain.

Does Medicare cover Mycophenolate or Cellcept?

Some Medicare Advantage plans and Medicare Part D plans in your area may cover Mycophenolate.

  • 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 Mycophenolate.

Find Medicare Advantage plans with drug coverage

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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 Mycophenolate 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

Take Mycophenolate on an empty stomach at least 1 hour before or 2 hours after meals unless your doctor has told you otherwise. Talk to your doctor before getting any vaccines, as some vaccines can raise the chance of infection while taking Mycophenolate.

If you are able to become pregnant, trusted birth control to prevent pregnancy is important while taking Mycophenolate. Mycophenolate can cause birth defects and death of an unborn baby.

Mycophenolate can increase your risk for cancers like lymphoma or skin cancer and can also increase your risk for bad infections. Signs of cancer include change in color or size of a mole, skin lump or growth, noticeable weight loss, night sweats or swollen glands.

Signs of infection include fever, chills, flu-like symptoms, sore throat, ear and sinus pain, cough or a wound that won’t heal. To reduce your risk of infection, wash your hands often and avoid people who are sick.

 

 

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.