Soltamox (Tamoxifen) Medicare Coverage

Soltamox
Chemical name: Tamoxifen

Brand name: Soltamox

Typical dosage: 150ml of 10mg/5ml

Typical type: Eye drop1

Soltamox is a medication that is used to treat and prevent breast cancer. Soltamox is available as a brand name drug or as a generic and comes as an oral liquid or an oral tablet.

Soltamox is a medication that contains the active ingredient Tamoxifen. Soltamox is used to treat breast cancer or prevent breast cancer in women who are at high risk for developing it in the future.

Soltamox blocks the effects of estrogen, which can stop the growth of cancerous tumor cells in the body. It is typically taken once dialy for 5 years or longer.

Common side effects of Soltamox include hot flashes, upset stomach, weight changes, fatigue, pain, dizziness, diarrhea, constipation, insomnia and anxiety.

Does Medicare cover Soltamox or Tamoxifen?

While some Medicare plans may not cover Soltamox, some Medicare Advantage plans and Medicare Part D plans may cover generic Tamoxifen.

  • 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 Tamoxifen.

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 Tamoxifen 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

If you are able to get pregnant, start taking Soltamox during your menstrual cycle. Talk to the doctor about the best time to start taking Soltamox.

Soltamox can increase the risk of stroke, blood clots or endometrial and uterine cancer.

Signs of a stroke include weakness or drooping on 1 side of the face or body, confusion, blurred eyesight or changes in balance.

Signs of a blood clot may include swelling, warmth, pain in 1 leg or arm or shortness of breath.

Soltamox may lead to increased prevalence of urinary tract infections. Symptoms of a urinary tract infection include blood in the urine, burning or pain while urinating and stomach pain.

 

 

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.