Donepezil (Aricept) Medicare Coverage

Donepezil
Chemical name: Donepezil

Brand name: Aricept

Typical dosage: 10mg

Typical type: Tablet1

Donepezil is a medication used to treat Alzheimer’s disease. Donepezil is available as a brand name or as a generic and comes as an oral tablet.

Donepezil is a medication typically used to treat mild, moderate and severe dementia related to Alzheimer’s disease. The brand name equivalent of Donepezil is called Aricept.

Donepezil is typically taken once daily. Donepezil increases a chemical in the brain to help improve symptoms of dementia.

Common side effects of Donepezil include dizziness, upset stomach, diarrhea, trouble sleeping, weight loss, muscle cramps and headache.

Does Medicare cover Donepezil or Aricept?

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

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Average costs for Donepezil 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.
$2 – $26 Free – $20

Additional information

It is best to take Donepezil at bedtime. You can take it with or without food. It is important to continuously keep taking Donepezil according to your doctor’s orders, even if you feel well.

Donepezil can help improve signs and symptoms of dementia but is not a cure for Alzheimer’s.

A condition called neuroleptic malignant syndrome can occur while taking Donepezil. If you experience symptoms of high temperature, abnormal pulse or blood pressure, abnormal heart beat, muscle stiffness or mental status changes, call your doctor.

This medication can lead to muscle problems. Talk to your doctor if you experience any muscle pain, tenderness, weakness, fever or see dark urine.

 

 

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. Donepezil. Retrieved May 2019, from www.goodrx.com/donepezil.

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.