Oxybutynin (Ditropan) Medicare Coverage

Oxybutynin
Chemical name: Oxybutynin

Brand name: Ditropan

Typical dosage: 5mg

Typical type: Tablet1

Oxybutynin is a medication used to treat overactive bladder. Oxybutynin is available as a brand name drug or as a generic and can come as a tablet or an oral syrup.

Oxybutynin is a medication used to manage symptoms of overactive bladder. It relaxes the muscles in the bladder in order to reduce the urge to use the bathroom. It also increases the capacity of your bladder and reduces contractions.

Oxybutynin is available in a variety of different forms including a topical gel, a patch, a syrup or an oral tablet in immediate- and extended-release forms. The brand name equivalent of Oxybutynin is called Ditropan.

Side effects of Oxybutynin include drowsiness, dizziness, blurry eyes, headache, upset stomach, constipation, diarrhea, dry mouth, insomnia or excitability.

The skin patch and gel may cause skin irritation, redness or itching where the product is used.

Does Medicare cover Oxybutynin or Ditropan?

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

  • 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 Oxybutynin.

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 Oxybutynin 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

Symptoms of an overactive bladder include a sudden urge to urinate that is difficult to control, involuntarily urinating right after feeling the urge to go to the bathroom, urinating frequently (eight or more times in 24 hours) or waking up 2 or more times throughout the night to urinate.

If you are 65 years or older, you may experience more side effects while taking Oxybutynin. Behavioral therapy such as urge suppression or bladder retraining is often prescribed for older adults.

If you use Oxybutynin, be aware of the sedation side effect and avoid doing activities that require your full attention.

 

 

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.