Fluoxetine (Prozac) Medicare Coverage

Fluoxetine is the generic form of the brand name drug Prozac.

Fluoxetine is used to treat many behavioral disorders including bipolar, bulimia, major depressive disorders, OCD and panic disorder. Fluoxetine is typically taken once daily, and the dose depends on what you are using it for.

Fluoxetine increases the amount of serotonin in the brain to decrease symptoms of the above disorders.

Common side effects include upset stomach, loss of appetite, diarrhea, dry mouth, sleepiness, strange dreams, insomnia, fatigue, flu-like symptoms, nervousness and headache.

How much does Fluoxetine cost with Medicare?

Fluoxetine 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 Fluoxetine?

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

• Medicare Advantage plans or Part D plans that cover Fluoxetine 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 Fluoxetine. 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

Fluoxetine starts working after a few weeks of taking it. It can sometimes take up to a few months to feel the full effect of the medication. Do not stop taking Fluoxetine unless your doctor tells you to, even if you feel better.

Fluoxetine is approved for use in some children, but not all. Talk to the doctor to be sure that this drug is right for your child. 

Fluoxetine can increase the risk of suicidal thoughts or actions. The risk of suicidal thoughts might be higher if you have experienced them in the past. If you experience signs of depressed mood, nervousness, restlessness, irritation or panic attacks, call your doctor.

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.