Does Medicare Cover Midodrine Scripts?

In this article...
  • Learn whether Medicare covers midodrine and what you pay when the drug is covered by a prescription drug plan. Discover what midodrine is and what it treats.

Medicare is made up of several parts that cover different things. Although original Medicare doesn’t cover any medications, you may get drug coverage through Medicare Advantage or a Medicare prescription drug plan. These plans may cover midodrine, a blood pressure medication. 

Does Medicare Cover Midodrine? 

The vast majority of Medicare prescription drug plans cover midodrine. If you require this medication, you should be able to find a plan in your area that covers it. 

What Is Midodrine Used For?

Midodrine is a drug that treats low blood pressure. In particular, it helps people who have low blood pressure when they go from sitting or lying down to standing. This is known as orthostatic hypotension. 

People with orthostatic hypotension experience dizziness, light-headedness or blurred vision when they stand up. Other symptoms of the condition include tiredness, nausea and an abnormal heartbeat. 

How to Use Midodrine

Midodrine works by tightening blood vessels in the body, which raises blood pressure. You should only take midodrine while you’re upright, as your blood pressure can be raised too much if you take it while lying down. 

Most people take a dose of midodrine three times a day. The effects of the drug last for 2-3 hours, so it can’t be taken too close to bedtime. It’s best to take the final dose of the day before dinner and at least 4 hours before going to bed. You may also want to prop up your head with pillows before going to sleep, as this lowers the risk of high blood pressure that comes from lying flat. 

How Much Does Midodrine Cost With Medicare?

Your midodrine costs depend on your prescription drug plan and how much you’ve paid for medications during the year. Many insurance plans have deductibles, which is the amount you have to pay before your plan starts covering prescription drugs. The maximum deductible for Medicare drug plans in 2022 is $480 and $505 in 2023.

If you’re still in the deductible stage, you may have to pay the full cost of midodrine. After meeting your deductible, your only cost will be the co-pay. This may be a flat fee or a percentage of the medication cost. 

Is There a Generic Version of Midodrine?

Midodrine is the generic name of this medication. The most common brand name is Proamatine. Generic brands can help you save money on the cost of the drug. 

How Do I Know if Midodrine Is Covered by My Plan?

Medicare drug plans have formularies that list all the prescription medications covered in the plan. You can get a copy of this list on your insurer’s website or by contacting their customer service department. Insurance companies can have different formularies for each plan, so it’s important to check the correct one. 

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