Nexterone (Amiodarone) Medicare Coverage

Nexterone is a antiarrhythmic medication that contains the active ingredient Amiodarone. Nexterone is used to control heart rhythm in atrial fibrillation.

It is typically taken once daily and can be given IV in the hospital or by mouth. It is typically administered by a health care provider or doctor, and it is usually not available at a retail pharmacy.

Common side effects of Nexterone include constipation, upset stomach, feeling tired or weak, loss of appetite, headache, insomnia, change in taste and smell and increased production of saliva.

How much does Nexterone cost with Medicare Advantage?

If Medicare Part B covers Nexterone treatments for you because you meet the qualifying conditions, you’ll typically pay 0% to 20% of the Medicare-approved amount for the Nexterone prescription price, after you meet your Part B deductible.

In 2024, the Medicare Part B deductible is $240 per year. Once you pay this amount, you’ll pay the remaining copay costs Medicare Part B doesn’t cover.

Does Medicare Advantage cover Nexterone?

Medicare Part B covers injectable and infused drugs administered by a medical provider for qualified beneficiaries.

You don’t need a Medicare Advantage plan or a Medicare Part D prescription drug plan to get Nexterone coverage.¹

If you have either type of private drug plan, you’re enrolled in Medicare Part B, and you qualify for Medicare coverage of Nexterone, your Part B benefits will cover Nexterone.

Some Medicare Advantage plans and Medicare Part D plans cover other prescription drugs that aren’t administered in a doctor’s office or by a medical professional.

• Part D plans or Medicare Advantage plans that cover drugs 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 prescription drugs. We represent carriers such as Humana, Aetna, UHC, Anthem BCBS, Wellcare, Cigna Healthcare, and 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

Nexterone can be taken with or without food, but you should take it the same way each time you take it.

Nexterone can affect other organs and systems in the body. First, it can lead to liver problems. You may have to get your liver checked regularly. Let your doctor know if you experience dark urine, abdominal pain, vomiting or yellowing of the skin and eyes.

Nexterone can also affect your lungs and your thyroid. Signs of lung problems include shortness of breath, cough or fever. Nexterone can cause your thyroid to not work less efficiently. This is called hypothyroidism.

Signs of hypothyroidism include changes in weight, fatigue, weakness, hair thinning, depression, issues with focus and intolerance to cold.

Since Nexterone can affect the eyes, be sure to let your doctor know if you experience any vision changes, eye pain or eye irritation.

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.