Cimzia® Medicare Coverage

Cimzia is a prescription medication that contains the active ingredient Certolizumab. Cimzia is a subcutaneous injection into the fatty part of the skin given every 2 to 4 weeks depending on the condition being treated.

Cimzia binds and neutralizes human TNF-alpha in the body to reduce inflammatory processes.

The major side effects of Cimzia include irritation where the shot is given and signs of a common cold.

Does Medicare cover Cimzia?

Yes! 37% of Medicare Advantage plans and Medicare Part D plans cover Cimzia.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 Cimzia.

Or call 1-800-557-6059 1-800-557-6059 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 Cimzia with Medicare drug coverage¹

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

Additional information

Tell your doctor you are taking Cimzia before getting any vaccines, as it may have an impact on their effectiveness.

While many patients can safely take Cimzia, patients who are pregnant or breastfeeding should take extra precautions. Talk to your doctor about the risks and benefits of the medication.

Patients treated with Cimzia are at a higher risk of developing serious infections including tuberculosis or invasive fungal, bacterial, viral or other opportunistic infections. Monitor closely for signs/symptoms of infection.

Wash your hands often and stay away from people who are sick.

Lymphoma and other cancers have occurred in patients who take Cimzia; be sure to talk with your doctor about the benefits and risks.

Use with caution if you have heart failure or kidney impairment. Patients taking Cimzia have experienced new-onset and worsening heart failure, and part of the drug may be dependent on kidney function.

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.