Movantik® Medicare Coverage

Movantik®
Chemical name: Naloxegol

Typical dosage: 25mg

Typical type: Tablet1

Movantik® is a medication used for constipation due to opioid (pain medicine) use. Movantik is brand name only and is available as an oral tablet.

Movantik is a prescription medication that contains the active ingredient Naloxegol. Movantik is taken once daily for the treatment of constipation from the use of opioids.

Movantik works on opioid receptors in the GI tract to decrease the constipation associated with opioids.

The most common side effects associated with Movantik include diarrhea, gas, headache, nausea, vomiting and belly pain.

Does Medicare cover Movantik?

Yes! 75% of Medicare Advantage plans and Medicare Part D plans cover Movantik.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 Movantik.

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Average costs for Movantik 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.
$350 – $409 $19 – $409

Additional information

You should stop all other maintenance laxative medications before starting Movantik. You may start laxatives as needed if Movantik is not working after 3 days.

This drug is only for use in patients who take certain pain medications. You should stop taking Movantik when you are no longer taking opioid pain medications.

This medication can cause withdrawals after stopping. Call your doctor if you have sweating, chills, diarrhea, stomach pain that is not normal, anxiety, irritability or excessive yawning.

This medication may not work as well for patients who have been taking pain medications for less than 4 weeks. You should not use this drug if you have severe liver problems.

While many patients can safely take Movantik, use during pregnancy can cause opioid withdrawal in the unborn baby. Breastfeeding is not recommended while using Movantik.

 

 

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. Movantik. Retrieved May 2019, from www.goodrx.com/movantik.

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.