Symbicort® Medicare Coverage

Symbicort®
Chemical name: Budesonide/Formoterol

Typical dosage: 160mcg/4.5mcg

Typical type: Inhaler1

Symbicort® is a medication typically used to treat asthma and COPD. Symbicort is a brand name only medication and is an inhaler.

Symbicort is a prescription medication that contains the active ingredients Budesonide and Formoterol. Symbicort is an inhaled solution that is used once to twice daily, depending on the condition being treated.

Budesonide is a corticosteroid that prevents and controls inflammation and formoterol acts on beta receptors to relax muscles in the airway.

The major side effects include headache, stomach pain, stuffy nose, nose and throat irritation, signs of a common cold, throat pain, back pain and throwing up.

Does Medicare cover Symbicort?

Yes! 80% of Medicare Advantage plans and Medicare Part D plans cover Symbicort.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 Symbicort.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Average costs for Symbicort 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.
$338 – $399 $19 – $399

Additional information

Symbicort should be shaken well before use.

You should rinse out your mouth after each time you use it to avoid an infection called thrush. Rinse your mouth with water and spit the water out.

It may take up to 2 weeks to see the full effect of Symbicort. Do not stop taking this medication without talking to your doctor first.

Symbicort is used for chronic treatment of asthma and COPD and should not be used as a rescue inhaler or to treat COPD exacerbations.

Long term use of Symbicort may increase the risk of cataracts or glaucoma, osteoporosis and infections like the cold or flu. In patients with COPD, Symbicort can increase the risk of getting pneumonia.

 

 

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. Symbicort. Retrieved May 2019, from www.goodrx.com/symbicort.

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.