Nolvadex (Tamoxifen) Medicare Coverage

Nolvadex is a medication used to treat breast cancer, including early stage breast cancer, ductal carcinoma (following breast surgery and radiation) and metastatic breast cancer. The generic form of Nolvadex is called Tamoxifen.

Novladex is also used to prevent breast cancer in woman who are at high risk or who have previously been treated for breast cancer.

Nolvadex is typically taken once daily for 5-10 years. Common side effects of Nolvadex include hot flashes, upset stomach, throwing up, drowsiness, back pain, bone pain, joint or muscle pain, dizziness, diarrhea, constipation, insomnia and anxiety.

How much does Tamoxifen cost with Medicare?

Tamoxifen 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 Tamoxifen?

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

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

Nolvadex can be taken with or without food. It is important to take Nolvadex as instructed to prevent or treat breast cancer.

If you are able to get pregnant, start taking Nolvadex during your menstrual cycle. Talk to your doctor if you are unsure when to start taking this drug.

Let your doctor know if you experience signs of high calcium levels including weakness, confusion, drowsiness, headache, upset stomach, throwing up, constipation or bone pain.

Urinary tract infections can happen while taking Nolvadex. Signs of a UTI include blood in the urine, burning or pain while urinating, feeling the need to urinate often, fever, lower stomach pain or pelvic pain.

Talk to your doctor immediately if you experience a lump in the breast or breast soreness, depression, swelling in the arms and legs, any skin changes or very bad headaches.

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.