Ondansetron (Zofran) Medicare Coverage

Ondansetron
Chemical name: Ondansetron

Brand name: Zofran

Typical dosage: 4mg

Typical type: Tablet1

Ondansetron is a medication used to treat nausea and vomiting, especially for patients undergoing cancer treatment. Ondansetron is available as a brand name or a generic and comes as an oral tablet, a dissolvable tablet and an oral liquid.

Ondansetron is the generic form of the brand name medication Zofran. Ondansetron is used to treat and prevent nausea and vomiting after operations, chemotherapy or radiation treatments.

Ondansetron is typically taken as needed to control nausea and vomiting. Ondansetron blocks serotonin in the brain and in the chemotherapy receptors to prevent and treat nausea.

Common side effects include headache, fatigue, diarrhea, constipation, fatigue and anxiety.

Does Medicare cover Ondansetron or Zofran?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Ondansetron.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 Ondansetron.

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Average costs for Ondansetron 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.
$1 – $2 Free – $2

Additional information

For the dissolvable tablet, place on tongue and let it dissolve. Water is not necessary. If you are using more than 1 dissolvable tablet, let each tablet dissolve one at a time.

Call your doctor if you experience fast or abnormal heart beat or if you pass out. This may be indicative of a more serious heart problem.

Serotonin syndrome can happen with Ondansetron, usually if you take it very often. Call your doctor if you experience agitation, changes in balance, confusion, fever, abnormal heartbeat, flushing, muscle problems, shaking, sweating, upset stomach or headache.

 

 

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. Ondansetron. Retrieved May 2019, from www.goodrx.com/ondansetron.

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.