Sulfamethoxazole-Trimethoprim (Bactrim) Medicare Coverage

Sulfamethoxazole-Trimethoprim
Chemical name: Sulfamethoxazole-Trimethoprim

Brand name: Bactrim, Sulfatrim, Septra

Typical dosage: 800mg/160mg

Typical type: Tablet1

Sulfamethoxazole-trimethoprim is an antibiotic used to treat a variety of different infections. It is available as a brand or as a generic and comes as an oral liquid, an IV liquid or an oral tablet.

Sulfamethoxazole-trimethoprim is an antibiotic typically used to treat many different infections including urinary infections, lung infections and COPD exacerbations due to bacteria.

The brand name equivalents of Sulfamethoxazole-trimethoprim include Bactrim, Sulfatrim and Septra. The dose varies depending on what type of infection you are treating.

This antibiotic stops the growth and reproduction of bacteria in the body. The major side effects with Sulfamethoxazole-trimethoprim include upset stomach, diarrhea and loss of appetite.

Does Medicare cover Sulfamethoxazole-Trimethoprim or Bactrim?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Sulfamethoxazole-trimethoprim.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 Sulfamethoxazole-trimethoprim.

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Average costs for Sulfamethoxazole-trimethoprim 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 – $24 $Free – $24

Additional information

It is very important to take your full course of antibiotics, even if you start to feel better. Your infection to return and get worse if you stop taking your antibiotics too soon.

Sulfamethoxazole-trimethoprim can be taken with or without food. This antibiotic should be taken with a full glass of water. It is also recommended to drink a lot of non-caffeinated liquids throughout the day.

Talk to your doctor if you have any severe side effects, especially if you experience severe diarrhea, as it may be indicative of a more serious condition.

People often have allergic reactions to antibiotics. Tell your doctor if you experience signs of an allergic reaction including rash, itchiness, hives or other reactions.

 

 

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. Sulfamethoxazole-Trimethoprim. Retrieved May 2019, from www.goodrx.com/sulfamethoxazole-trimethoprim.

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.