Epipen® Medicare Coverage

Epipen is a prescription medication that contains the active ingredient Epinephrine. Epipen is given in the event of emergency allergic reaction. It is injected into the muscle and can be used every 5 to 15 minutes if allergic reaction symptoms don’t resolve.

Epipen stimulates beta-receptors in the body that relax muscles in the throat and stimulate the heart to carry more oxygen through the body.

The most common side effects from Epipen include feeling excited or nervous, anxiety, restlessness, shakiness, nausea and vomiting, sweating, headache and fast heart rate.

How much does Epipen cost with Medicare?

Epipen 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 Epipen?

According to GoodRx, 99% of Medicare Advantage plans and Medicare Part D plans covered Epipen in 2023.¹

• Medicare Advantage plans or Part D plans that cover Epipen 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 2023 Medicare Advantage plans included 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 Epipen. 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

If you use Epipen, you should keep this medicine with you at all times in case of an allergic reaction.

Epipen should be injected into the outer part of the mid-thigh to manage an emergency allergic reaction. Each Epipen contains only 1 dose.

In the event of an emergency allergic reaction, you need to visit a hospital as soon as possible, even after use of the Epipen. It is recommended to give one dose for every 10 to 20 minutes of travel time to an emergency room.

More than 2 Epipen doses should only be administered under direct medical supervision. Do not inject into the fingers, hands or feet, because this can lower blood flow to these areas.

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.