Plavix (Clopidogrel) Medicare Coverage

Plavix
Chemical name: Clopidogrel

Brand name: Plavix

Typical dosage: 75mg

Typical type: Tablet1

Plavix is a medication used to treat a variety of cardiac conditions. It is available as a brand name drug or as a generic and is an oral tablet.

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.

Does Medicare cover Plavix or Clopidogrel?

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

  • 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 Clopidogrel.

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 Plavix 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

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.