Nuplazid® Medicare Coverage

Nuplazid is a prescription medication that contains the active ingredient Pimavanserin. Nuplazid is given by mouth once daily.

Nuplazid blocks serotonin receptors to improve psychosis symptoms.

The most common side effects of Nuplazid are upset stomach and mental sluggishness.

How much does Nuplazid cost with Medicare?

Nuplazid 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 Nuplazid?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Nuplazid in 2023.¹

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

Nuplazid can be taken with or without food, but upset stomach may be improved if you take it with a meal.

Do not stop taking this medication if you start to feel better. This medication should not be stopped abruptly.

Nuplazid may increase the risk of death in elderly patients with dementia-related psychosis and should be used with caution.

This drug may cause an abnormal heartbeat called a prolonged QT interval.

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.