Gabapentin (Neurontin) Medicare Coverage

Gabapentin
Chemical name: Gabapentin

Brand name: Neurontin

Typical dosage: 300mg

Typical type: Capsule1

Gabapentin is a medication used to treat nerve pain and certain types of seizures. It is available as a generic or as the brand name drug Neurontin. It is available as an oral tablet, oral capsule or liquid solution.

Gabapentin is a medication indicated to treat nerve pain and partial seizures. Gabapentin can be taken 1-3 times daily, depending on the extent of the condition you are treating.

Gabapentin binds to parts of the brain in order to reduce the perception of pain related to nerves, and it increases the threshold for seizures.

Common side effects of Gabapentin include upset stomach, vomiting, diarrhea, dizziness, drowsiness, dry mouth and feeling weak.

Does Medicare cover Gabapentin or Neurontin?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Gabapentin.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 Gabapentin.

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Average costs for Gabapentin 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.
$4 – $47 Free – $30

Additional information

Even if you start to feel better after taking Gabapentin, do not stop taking Gabapentin suddenly without talking to your doctor, as it may cause you to have side effects.

Gabapentin can be taken with or without food. Take it with food if it causes an upset stomach to help avoid that side effect.

Gabapentin can cause you to become tired or dizzy. This can impair your ability to do daily tasks. Be cautious about things like driving when you first begin taking Gabapentin.

Use with caution if you have kidney problems or if you have a history of substance abuse including: alcohol, benzodiazepines, cannabis, cocaine or opioids. Tolerance and dependence on Gabapentin can develop.

Gabapentin may increase the risk of suicidal thoughts and behavior as early as 1 week after starting the medication. Talk to your doctor if you have signs of depression, nervousness, restlessness, panic attacks or negative 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.