Plaquenil (Hydroxychloroquine) Medicare Coverage

Plaquenil is a medication that contains the active ingredient Hydroxychloroquine. Plaquenil is used to treat lupus erythematosus, malaria and acute rheumatoid arthritis.

Plaquenil is typically taken 1-2 times daily and is used for at least 3 months.

Common side effects of Plaquenil include dizziness, headache, nervousness, weight loss, upset stomach, diarrhea, fatigue, change in skin or hair color and hair loss.

How much does Hydroxychloroquine cost with Medicare Advantage?

Hydroxychloroquine 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 Advantage cover Hydroxychloroquine?

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

• Medicare Advantage plans or Part D plans that cover Hydroxychloroquine 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 Hydroxychloroquine. 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

Take Plaquenil with food or with a glass of milk. Avoid taking antacids within 4 hours of taking Plaquenil.

Plaquenil can lead to serious eye problems. Your risk for eye problems can be higher if you have kidney problems. The risk may also be higher if you take high doses of Plaquenil.

Talk to the doctor if you experience eyesight changes, trouble focusing your eyes, difficulties while reading or trouble seeing in dim light.

Low blood cell counts have occurred in some patients while taking Plaquenil. Low blood counts can increase your risk for developing an infection, anemia and can increase bleeding problems.

Tell your doctor immediately if you experience symptoms of an infection, if you have any abnormal bleeding or bruising or if you feel very tired or weak.

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.