Diamox (Acetazolamide) Medicare Coverage

Diamox
Chemical name: Acetazolamide

Brand name: Diamox

Typical dosage: 250mg

Typical type: Tablet1

Diamox is a medication used to treat altitude sickness, swelling, eye problems and epilepsy. Diamox is available as a brand name or a generic and comes as an oral capsule, an oral tablet or an injection. 

Diamox is a medication that contains the active ingredient Acetazolamide. Diamox is used to prevent or treat altitude sickness and can also be used to treat swelling due to certain drugs or heart failure.

Diamox is also used in patients with glaucoma with elevated eye pressure and is also used to treat epilepsy.   It is typically taken anywhere from 1-4 times daily, depending on what condition you are using it to treat.

Diamox works to help reduce the build-up of fluids in the body and specifically in the eye.

Common side effects of Diamox include upset stomach, vomiting, change in taste, diarrhea, burred eyesight, fatigue, headache and dizziness.

Does Medicare cover Diamox or Acetazolamide?

While some Medicare plans may not cover Diamox, 100% of Medicare Advantage plans and Medicare Part D plans cover Acetazolamide.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 Acetazolamide.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Average costs for Acetazolamide 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.
$7 – $88 $3 – $88

Additional information

Diamox should be taken several hours before you go to bed. It can make you urinate more often, which can wake you up throughout the night if you take it too late.

Watch for signs of too much acid in the blood or electrolyte problems. Signs of these conditions include mood changes, confusion, upset stomach, abnormal heartbeat, fatigue and seizures. Tell your doctor if you experience any of these symptoms.

Also let your doctor know if you have a change in eyesight, change in hearing or a ringing that happens in your ears while taking Diamox.

Liver problems, blood problems and skin reactions have happened to people taking Diamox. If you experience any abnormal side effects, tell your doctor. Serious conditions are rare while taking Diamox, but they can happen.

 

 

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.