Acetaminophen-Codeine (Tylenol/Codeine) Medicare Coverage

Acetaminophen-Codeine
Chemical name: Acetaminophen-Codeine

Brand name: Tylenol with Codeine

Typical dosage: 300mg/30mg

Typical type: Tablet1

Acetaminophen and codeine are used as a medication combination to treat pain. Acetaminophen-codeine is available as brand name and as a generic and is available as an oral tablet or oral liquid.

Acetaminophen-codeine is a combination of two different medications to treat mild to moderate pain. The brand name equivalent is Tylenol with codeine.

Acetaminophen-codeine is a schedule 3 controlled substance due to its potential for abuse and addiction.

Acetaminophen-codeine is typically given for a short period of time for acute pain management. The major side effects of Acetaminophen-codeine include dizziness, constipation, stomach pain, upset stomach, vomiting, sweating and headache.

Does Medicare cover Acetaminophen-codeine or Tylenol?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Acetaminophen-codeine.1

  • 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.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 Acetaminophen-codeine.

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Average costs for Acetaminophen-codeine with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

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.
$2 – $40 Free – $40

Additional information

You can take this medication with or without food, but you can take it with food if acetaminophen with codeine upsets your stomach.

Acetaminophen-codeine is an addictive pain medication that can lead to abuse and misuse. This can lead to overdose or death. Only use acetaminophen with codeine as prescribed by your doctor.

This medication can also cause breathing problems. Call your doctor if you experience slow or shallow breathing.

Codeine is an opioid pain medication. When used with other drugs like benzodiazepines or alcohol, this medication can make you extremely drowsy. Side effects include slowed breathing and even death.

Benzodiazepine drugs are drugs like alprazolam, diazepam and lorazepam.

 

 

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.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Acetaminophen-Codeine. Retrieved May 2019, from www.goodrx.com/acetaminophen-codeine.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.