Plaquenil (Hydroxychloroquine) Medicare Coverage

Plaquenil
Chemical name: Hydroxychloroquine

Brand name: Plaquenil

Typical dosage: 200mg

Typical type: Tablet1

Plaquenil is a medication used to treat lupus, malaria and rheumatoid arthritis. Plaquenil is available as a brand name or generic drug and comes as an oral tablet.

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.

Does Medicare cover Plaquenil or Hydroxychloroquine?

While some Medicare plans may not cover Plaquenil, some Medicare Advantage plans and Medicare Part D plans in your area may cover generic Hydroxychloroquine.

  • 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 Hydroxychloroquine.

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 Hydroxychloroquine 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 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.