Alendronate (Fosamax) Medicare Coverage

Alendronate
Chemical name: Alendronate

Brand name: Fosamax

Typical dosage: 70mg

Typical type: Tablet1

Alendronate is a medication used to treat bone diseases including osteoporosis and Paget’s disease. Alendronate is available as a brand name or a generic and comes as an oral tablet or solution.

Alendronate is a medication used to stop the progression of bone diseases including osteoporosis and Paget’s disease. The brand name equivalent of Alendronate is called Fosamax.

Alendronate is typically taken 1 time a week. This drug works by blocking substances that deteriorate your bones. This increases bone mineral density and helps prevent future bone damage and fractures.

Major side effects of Alendronate include stomach pain, upset stomach, vomiting, headache, constipation, diarrhea and muscle or joint pain.

Does Medicare cover Alendronate or Fosamax?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Alendronate.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 Alendronate.

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Average costs for Alendronate 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.
Free – $13 Free – $13

Additional information

You should take Alendronate on an empty stomach before breakfast. Take Alendronate at least 30 minutes before your first food, drink or other medications of the day.

Do not lie down for at least 30 minutes after taking Alendronate and until after you eat some food. If you take the oral tablets, drink a full glass of water with your dose. If you are using the oral liquid, drink a cup of water after taking your full dose.

Even if you feel fine, take this medication as directed by your doctor.

This medication can cause problems with the jawbone. The risk of jawbone problems increases the longer you take Alendronate. This risk may be higher if you have dental problems, cancer, dentures that do not fit well, anemia, blood clotting problems or an infection.

Talk to your doctor about this side effect if you are having dental work. Call your doctor if you are having jaw swelling or 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.

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

1 GoodRx. Alendronate. Retrieved May 2019, from www.goodrx.com/alendronate.

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.