Oxycontin Medicare Coverage

Oxycontin is an opioid medication that contains the long acting form of oxycodone. Oxycontin is a schedule II medication due to its potential for abuse.

Oxycontin works in the brain to help reduce the symptoms of pain. This medication should be used carefully, as it has a high potential for addiction.

Common side effects include dizziness, fatigue, headache, trouble sleeping, itching, dry mouth and upset stomach.

Does Medicare cover Oxycontin?

No. Medicare Advantage plans and Medicare Part D plans do not typically cover Oxycontin.¹

You may be able to find Medicare Advantage plans or Part D plans that cover other drugs that help treat pain.

• 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.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Average costs for Oxycontin with Medicare drug coverage¹

Because Medicare Advantage plans and Medicare Part D plans do not typically cover Oxycontin, you will likely be responsible for all costs for this drug if you have one of these types of Medicare coverage.

Additional information

You can take Oxycontin with food to avoid getting an upset stomach. Talk to your doctor before taking other medications with Oxycontin.

Taking too much Oxycontin 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 anyone, including children, accidentally takes oxycontin or if you take too much by accident, get emergency help right away.

Overdoses of opioid medications can happen. Do not take more Oxycontin that your doctor has instructed.

Signs of an overdose include passing out, problems with talking, trouble breathing, choking and vomiting. Get emergency help if you or another person experiences these side effects.

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.