Baclofen (Gablofen/Lioresal) Medicare Coverage

Baclofen
Chemical name: Baclofen

Brand name: Gablofen, Lioresal

Typical dosage: 10mg

Typical type: Tablet1

Baclofen is a medication used to treat muscle spasms. Baclofen is available as a generic oral tablet or as a name brand drug.

Baclofen is a medication typically used to treat muscle spasms associated with multiple sclerosis or spinal cord injury. The brand name equivalents of Baclofen include Gablofen and Lioresal.

Baclofen is taken up to 3 times daily for the most benefit. Baclofen blocks nerves in the brain that make muscles contract, which can help relax your muscles.

Common side effects include fatigue, insomnia, upset stomach, headache and constipation.

Does Medicare cover Baclofen or Gablofen?

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

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Average costs for Baclofen 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.
$1 – $1,284 Free – $1,060

Additional information

You can take Baclofen with or without food. If Baclofen upsets your stomach, taking it with meals may help.

Call your doctor if you experience dizziness, extreme confusion, fatigue or a change in how often you urinate.

Some unsafe side effects have occurred while taking Baclofen. These side effects can happen all of a sudden. Call your doctor if you experience high fever, mental changes, increased muscle spasms or muscle stiffness.

Avoid stopping Baclofen suddenly without first talking to your doctor.

 

 

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. Baclofen. Retrieved Sep. 2019, from www.goodrx.com/baclofen.

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.