Does Medicare Cover GoLYTELY?
- GoLYTELY is a laxative used to clear out the bowel before some diagnostic tests. This article outlines Medicare coverage for GoLYTELY and PEG 3350 medications.
GoLYTELY is a type of laxative used to clear out the colon before a colonoscopy and barium enema X-ray. It contains an osmotic laxative called PEG 3350 and electrolytes to prevent electrolyte imbalance.
This medication comes as a powder to mix with 1 gallon of water. Usually, doctors advise people using GoLYTELY to drink around 240 milliliters every 10 minutes until they finish the entire dose or they pass only clear liquid from the rectum. Your doctor may also tell you to eat lightly before taking your medication and abstain from consuming red or purple drinks. Some people find the taste of GoLYTELY unpleasant, and chilling it can make it more palatable.
GoLYTELY Side Effects
You should expect to experience diarrhea after taking GoLYTELY, as this effect is necessary to cleanse the colon. Occasionally, GoLYTELY can cause other side effects, which may include:
- Bloating
- Feeling uncomfortably full
- Nausea
- Soreness or itching around the anus
- Vomiting
- Stomach cramps
Does Medicare Cover GoLYTELY?
Probably not; people enrolled in Medicare Parts A and B (Original Medicare) are unlikely to be entitled to GoLYTELY coverage. However, 99% of Medicare supplemental drug coverage policies cover GoLYTELY or a generic alternative.
Therefore, you're highly likely to have coverage if you have Part D or a Medicare Advantage plan that covers prescriptions. Prescription drug coverage isn't a mandatory Medicare benefit, but many of the top-rated Medicare Advantage plans include it.
If your plan doesn't cover GoLYTELY specifically, it will likely cover an unbranded PEG 3353 and electrolytes medication. These medications generally come under Tier 2 of your insurer's formulary (covered medications list).
How Much Will I Pay for GoLYTELY With Medicare?
GoLYTELY costs around $29 to $66 for a 4-liter bottle without insurance coverage, although you could pay less if you subscribe to a medication discount service. Whether you have to pay for GoLYTELY out of pocket depends on your deductible status. If you haven't met your yearly deductible, you'll pay the full cost of your medication.
However, if you've already paid your deductible, your insurer will pay for GoLYTELY if you're eligible for coverage. Most Medicare Part D and Medicare Advantage companies don't charge co-pays for GoLYTELY.
Medicare Coverage Restrictions for GoLYTELY
Coverage for GoLYTELY is usually unrestricted for Medicare Part D and Medicare Advantage enrollees.
