Ritalin (Methylphenidate) Medicare Coverage

Ritalin is a schedule II controlled medication used to treat attention deficit/hyperactivity disorder (ADD or ADHD) and symptoms of narcolepsy. The generic form of Ritalin is called Methylphenidate.

Ritalin Immediate Release (IR) is typically taken twice daily, while Ritalin Sustained Release (SR) is typically taken once daily.

Ritalin is a stimulant of the brain and increases levels of norepinephrine and dopamine. Common side effects of Ritalin include dizziness, sleepiness, dry mouth, headache, upset stomach, loss of appetite, insomnia and nose and throat irritation.

Does Medicare cover Ritalin or Methylphenidate?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Methylphenidate, the generic form of Ritalin. Most Medicare plans don't cover the brand name form of Ritalin.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 Methylphenidate.

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

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.

Average costs for Methylphenidate (Ritalin) with Medicare drug coverage¹

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Additional information

Ritalin should be taken 30-45 minutes before eating a meal. If you take Ritalin more than 1 time daily, take your second dose before 6pm to avoid insomnia.

Long acting (sustained release) Ritalin should be taken in the morning. Talk to your pharmacist about how to take the medication properly.

Ritalin is a schedule II controlled substance due to its high potential for abuse, misuse and addiction.

Ritalin can sometimes cause heart problems. Talk to your doctor if you experience an abnormal heartbeat, weakness on one side of the body, trouble speaking or thinking, chest pain or pressure, shortness of breath, dizziness or fainting.

Changes in mood and behavior have occurred while taking Ritalin. If you have a change in thinking, increased anger, hallucinations, depression or mood swings, talk to your doctor immediately.

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.