Lyrica® Medicare Coverage

Lyrica is a schedule V prescription medication that contains the active ingredient Pregabalin.

It is typically taken 1-3 times daily, depending whether you are taking it for nerve pain, seizures or fibromyalgia. Lyrica works by modifying nerve signals that are associated with seizures and pain.

Common side effects of Lyrica include dizziness, drowsiness, dry mouth, constipation, swelling, blurred vision and weight gain.

How much does Pregabalin cost with Medicare?

Pregabalin 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 Pregabalin?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Pregabalin, the generic form of Lyrica, in 2023.¹

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

Lyrica is a schedule V medication due to its low potential for abuse. While many patients can safely use Lyrica, information is limited in pregnancy, and it could pose a risk to the developing fetus. Breastfeeding is not recommended during Lyrica therapy.

Use with caution if you have heart failure, kidney abnormalities or a history of substance abuse.

Swelling from the use of Lyrica can become life threatening. Symptoms include facial, mouth, and neck swelling. If you have a history of edema, use caution when taking this drug and talk to your doctor immediately if you experience swelling.

Lyrica 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.

If you are taking Lyrica, do not stop the medication without advice from a doctor. You should avoid drinking alcohol while using Lyrica because it may increase the sedative effects of the drug.

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.