Hydrocodone-Acetaminophen (Vicodin/Lorcet/Norco) Medicare Coverage

Hydrocodone-Acetaminophen
Chemical name: Hydrocodone/Acetaminophen

Brand name: Vicodin, Lorcet, Lortab, Norco, Xodol, Hycet

Typical dosage: 10mg/235mg

Typical type: Tablet1

Hydrocodone-Acetaminophen is a medication used to treat pain. It is available as a generic drug and a brand name equivalent.

Hydrocodone-acetaminophen is a schedule II opioid medication used to treat pain. The brand name equivalents include Norco, Xodol, Hycet, Lortab, Lorcet and Vicodin.

This medication binds to receptors in the brain that help relieve pain.

Hydrocodone is a very addictive medication and should be used carefully.

Common side effects of hydrocodone-acetaminophen include constipation, dizziness, drowsiness, upset stomach, weakness, headache or stomach pain. More serious side effects are described below.

Does Medicare cover Hydrocodone-Acetaminophen or Vicodin?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Hydrocodone-acetaminophen.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 Hydrocodone-acetaminophen.

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Average costs for Hydrocodone-Acetaminophen 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.
$7 – $69 $4 – $51

Additional information

Hydrocodone-acetaminophen can be taken with or without food. If you get an upset stomach, taking it with food may help avoiding an upset stomach in the future.

Do not combine this pain medicine with any other pain medicines, even those you can buy over the counter.

Taking too much hydrocodone-acetaminophen can cause an overdose. Opioid overdoses are common due to the potency of these types of pain medications. Always take your pain medicine only as directed.

If anyone – especially a child – accidentally takes hydrocodone-acetaminophen, or if you take too much by accident, get emergency help right away.

Signs of an overdose include loss of consciousness, unresponsiveness, slow breathing, vomiting, body limpness, slowed or missing pulse and other symptoms.

In case of an overdose, an opioid reversal agent called Narcan may be available. Talk to your doctor or pharmacist about getting Narcan with your opioid prescription.

Use of hydrocodone-acetaminophen with benzodiazepine medications or alcohol may increase the risk of life-threatening breathing problems. Avoid these substances while taking opioids.

 

 

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.