Avastin Medicare Coverage

Avastin is administrated as an IV infusion over a period of time by a licensed healthcare provider in a healthcare facility. You cannot fill a prescription for Avastin at a retail pharmacy.

Avastin is a prescription medication that contains the active ingredient Bevacizumab.

Avastin is used to treat many types of cancer including cervical, colorectal, glioblastoma, lung cancer, ovarian and renal cell carcinoma. Avastin is given by IV every 2 to 3 weeks depending on what type of cancer is being treated.

Avastin prevents the body from growing certain types of blood vessels to cancer cells. This helps to decrease the growth of cancer cells by starving the cells of nutrients they need to grow.

How much does Avastin cost with Medicare Advantage plans?

If Medicare Part B covers Avastin treatments for you because you meet the qualifying conditions, you’ll typically pay 0% to 20% of the Medicare-approved amount for the Avastin prescription price, after you meet your Part B deductible.

In 2024, the Medicare Part B deductible is $240 per year. Once you pay this amount, you’ll pay the remaining copay costs Medicare Part B doesn’t cover.

Does Medicare cover Avastin?

Medicare Part B covers injectable and infused drugs administered by a medical provider for qualified beneficiaries.

You don’t need a Medicare Advantage plan or a Medicare Part D prescription drug plan to get Avastin coverage.¹

If you have either type of private drug plan, you’re enrolled in Medicare Part B, and you qualify for Medicare coverage of Avastin, your Part B benefits will cover Avastin.

Some Medicare Advantage plans and Medicare Part D plans cover other prescription drugs that aren’t administered in a doctor’s office or by a medical professional.

• Part D plans or Medicare Advantage plans that cover drugs 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 can find out if Medicare Advantage plan options in your area cover prescription drugs. 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

Avastin is a chemotherapy medication that has a lot of potential side effects.

The following side effects are common, but not all patients experience all of the side effects listed: generalized weakness, pain, abdominal pain, nausea and vomiting, poor appetite, constipation, upper respiratory infection, low white blood cell count (increasing the risk of infection), kidney problems, nose bleed, diarrhea, hair loss, mouth sores and headache.

Avastin may cause severe holes in the GI tract (fistulas), bleeding problems and issues with wound healing. Talk with your doctor about your risk, especially if you notice any unusual bleeding or are planning on having any surgery.

You may have a higher risk of getting an infection with Avastin. Stay away from people who are sick and wash your hands often. Call your doctor if you have any signs of infection.

Avastin should not be used in patients with heart failure, and it may worsen high blood pressure. Avastin may also cause reactions during the infusion of the medication.

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.