Nolvadex (Tamoxifen) Medicare Coverage

Nolvadex
Chemical name: Tamoxifen

Brand name: Nolvadex

Typical dosage: 20mg

Typical type: Tablet1

Nolvadex is a medication used to treat breast cancer. Nolvadex is available in the generic form as Tamoxifen and comes as an oral tablet.

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.

Does Medicare cover Nolvadex or Tamoxifen?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Tamoxifen, the generic form of Nolvadex. Most Medicare Advantage plans and Medicare Part D plans don't cover Nolvadex.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 Tamoxifen.

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Average costs for Tamoxifen (Nolvadex) 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.
Free – $50 Free – $50

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.