Famotidine (Pepcid) Medicare Coverage

Famotidine
Chemical name: Famotidine

Brand name: Pepcid

Typical dosage: 20mg

Typical type: Tablet1

Famotidine is a medication used for the treatment of Gastroesophageal reflux disease (GERD), heartburn, acid reflux and intestinal ulcers. Famotidine is available as a brand name drug or a generic and comes as an oral tablet or oral syrup.

Famotidine is the generic form of the brand name medication called Pepcid. Famotidine is used to treat gastroesophageal reflux disease (GERD), heartburn and intestinal ulcers.

Famotidine is typically taken twice daily. Famotidine blocks histamine, which inhibits gastric acid from being created in the stomach.

The most common side effects of Famotidine include headache, upset stomach, constipation, stomach pain and diarrhea.

Does Medicare cover Famotidine or Pepcid?

Yes! 98% of Medicare Advantage plans and Medicare Part D plans cover Famotidine.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 Famotidine.

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Average costs for Famotidine 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.
$1 – $21 Free – $21

Additional information

Famotidine can be given as a prescription by your doctor or can be bought over the counter from your pharmacy. You can take Famotidine with or without food. Take Famotidine with food if your stomach is upset after taking it.

Talk to your doctor if you are taking other medications with Famotidine.

Famotidine can sometimes cause liver problems. Signs of liver problems include dark urine, fatigue or yellow skin and eyes. Talk to your doctor if you experience any of these symptoms.

 

 

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. Famotidine. Retrieved May 2019, from www.goodrx.com/famotidine.

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.