Sinemet (Carbidopa/Levodopa) Medicare Coverage

Sinemet
Chemical name: Carbidopa/Levodopa

Brand name: Sinemet

Typical dosage: 25mg/100mg

Typical type: Tablet1

Sinemet is a medication used to treat Parkinson’s disease. Sinemet is available as a brand name drug or a generic and comes as an oral tablet.

Sinemet is a medication that contains a combination of two active ingredients, Carbidopa and Levodopa. Sinemet increases levels of dopamine in the brain, which is thought to help Parkinson’s disease symptoms.

Sinemet comes as an immediate release tablet that is taken 3-4 times daily or an extended release tablet that is taken 2 times daily.

Common side effects of Sinemet include upset stomach, nightmares, constipation, dizziness, dry mouth, headache and insomnia.

Does Medicare cover Sinemet or Carbidopa/Levodopa?

While some Medicare plans may not cover Sinemet, 100% of Medicare Advantage plans and Medicare Part D plans cover Carbidopa/Levodopa.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 Carbidopa/Levodopa.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call 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 Carbidopa/Levodopa 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.
Free – $28 Free – $28

Additional information

If you are 65 years or older, you may experience more side effects while taking Sinemet. This may cause your urine, sweat and saliva to appear dark red, brown or black. This is normal and should not be a cause for concern.

Sinemet can make you feel very sleepy. Some people who take it have fallen asleep while doing important activities such as driving. This can happen for up to 1 year of starting the drug. If you feel the side effects of becoming especially sleepy, do not drive or do other important tasks.

If you have any fever, muscle cramps, stiffness, dizziness, headache, confusion or abnormal heartbeat, call your doctor. Sinemet can sometimes cause a more serious condition called neuroleptic malignant syndrome, which can cause these symptoms.

 

 

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.