Enbrel® Medicare Coverage

Enbrel is a prescription medication that contains the active ingredient Etanercept. Enbrel is typically taken once to twice weekly and is injected subcutaneously into the fatty part of the skin.

Enbrel blocks the actions of a receptor called TNF-alpha to reduce inflammation and relieve symptoms.

The major side effects of Enbrel include irritation at the injection site, diarrhea, headache, runny nose, stuffy nose and throat irritation. Additionally, there are mental side effects to be taken into account, such as anxiety and depression.

Does Medicare cover Enbrel?

Yes! 76% of Medicare Advantage plans and Medicare Part D plans cover Enbrel.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 Enbrel.

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 Enbrel with Medicare drug coverage¹

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

Enbrel Cancer Risk and Other Factors

Lymphoma and other malignancies have been reported in children and adolescents taking Enbrel. This medication should be used with caution in patients with alcoholic hepatitis, heart failure and seizure disorders.

Women who are pregnant or breastfeeding should talk to their doctor about the risks and benefits of Enbrel before starting this medication. Benzoyl alcohol is occasionally used in the diluent for injection and can be toxic to newborns and fetuses.

You should be up to date on your immunizations before starting Enbrel.

Enbrel may increase the risk for serious infections, which may result in hospitalization or death. Infections usually develop in patients receiving other immunosuppressive agents while taking Enbrel.

Active tuberculosis, invasive fungal and bacterial and viral infections have been reported. If you are taking Enbrel, watch for signs and symptoms of infection during and after treatment.

Wash your hands often and stay away from people who are sick. This drug should be stopped if you develop a serious infection or sepsis.

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.