Plavix (Clopidogrel) Medicare Coverage

Plavix is a medication that contains the active ingredient Clopidogrel. It is an antiplatelet medication used to prevent strokes in people with heart disease, including those who have had a heart attack or a history of acute coronary syndrome.

Plavix prevents platelets from clumping together, which helps prevent blockages from happening in the blood vessels. It is typically taken once daily.

Plavix is typically well tolerated.

How much does Clopidogrel cost with Medicare Advantage?

Clopidogrel 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 Clopidogrel?

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

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

Taking Plavix is important to prevent heart disease and to decrease your risk of having a stroke or heart attack. Take it for as long as your doctor instructs you to.

Some people only take Plavix for a year, while others take Plavix for the rest of their life. It depends on your particular heart health. You may not be able to feel immediate effects of Plavix working.

You can bleed more easily while taking Plavix. Be careful to avoid injury. Signs of major bleeding problems include throwing up blood, black or tarry stools, bleeding from the gums, excessive bruising or other abnormal bleeding.

Let your doctor know right away if you suffer a fall, as you should be checked for any bleeding on the inside of the body.

A severe blood problem called thrombotic thrombocytopenic purpura (TTP) has occurred in some cases of people taking Plavix. Tell your doctor right away if you experience confusion, fatigue, you have trouble speaking, a change in balance or a change in eyesight.

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.