Oxycodone (Roxicodone) Medicare Coverage

Oxycodone
Chemical name: Oxycodone

Brand name: Roxicodone

Typical dosage: 10mg

Typical type: Tablet1

Oxycodone is a medication used to treat pain. It is available as a generic or as a brand name drug and is an oral tablet.

Oxycodone is a schedule II opioid medication used to treat pain. It binds to receptors in the brain and in the central nervous system to help relieve pain.

Oxycodone is a very addictive medication and should be used carefully. The brand name equivalent of Oxycodone is called Roxicodone.

Common side effects of Oxycodone done include constipation, dizziness, drowsiness, upset stomach, headache and stomach pain. More serious side effects are described below.

Does Medicare cover Oxycodone or Roxicodone?

Yes! 99% of Medicare Advantage plans and Medicare Part D plans cover Oxycodone.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 Oxycodone.

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Average costs for Oxycodone 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.
$7 – $57 $4 – $51

Additional information

Oxycodone can be taken with or without food. If you get an upset stomach, taking it with food may help avoiding upset stomach in the future. Do not combine this pain medicine with any other pain medicines, even those you can buy over the counter.

Taking too much Oxycodone can cause an overdose. Opioid overdoses are very common due to the potency of these types of pain medications. Always take your pain medicine only as directed. If you take too much by accident, get emergency help right away.

Signs of an overdose include loss of consciousness, unresponsiveness, inability to talk and slowed or stopped breathing. In case of an overdose, an opioid reversal agent called Narcan may be available.

Talk to your doctor or pharmacist about getting Narcan with your Oxycodone prescription.

Use of these medications with benzodiazepine medications or alcohol may increase the risk of life-threatening breathing problems. Avoid these substances while taking opioids.  

 

 

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.