Duloxetine (Cymbalta) Medicare Coverage

Duloxetine is a medication typically used to treat generalized anxiety disorder (GAD), depression, chronic pain in the knees and back and nerve pain associated with diabetes. The brand name equivalent of Duloxetine is called Cymbalta.

Duloxetine is typically taken once daily, and your dose depends on what you are treating and how well you react to the medication.

Duloxetine increases serotonin and norepinephrine in the brain to reduce symptoms. Major side effects of Duloxetine include constipation, stomach upset, headache, dry mouth, trouble sleeping, fatigue, sweating and weight loss.

How much does Duloxetine cost with Medicare?

Duloxetine coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Duloxetine?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Duloxetine in 2023.¹

• Medicare Advantage plans or Part D plans that cover Duloxetine 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 2024 Medicare Advantage plans include 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 may be able to find Medicare Advantage plan options in your area that cover Duloxetine. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or 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

It is important to take Duloxetine exactly as your doctor has prescribed. If you stop Duloxetine too quickly, it can cause withdrawal symptoms and very bad side effects.

If you feel that you want to stop your Duloxetine, talk to your doctor.

Taking Duloxetine can increase your risk of bleeding if you take it with other medications that thin your blood like anticoagulants or pain medications like ibuprofen, naproxen and aspirin. Signs of bleeding can include blood in the urine or stool, excess bruising or any bleeding that is unusual or will not stop.

Liver problems can occur while taking Duloxetine. Call your doctor if you experience stomach pain, throwing up or yellow skin or eyes.

Duloxetine can increase the risk of suicidal thoughts in some people. Call your doctor if you experience suicidal thoughts, nervousness, restlessness, grouchiness, panic attacks or changes in mood or actions.

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.