Does Medicare Cover Montelukast?
- Montelukast can treat breathing problems, such as the wheezing that may occur with asthma. This article outlines which Medicare plans cover montelukast and how much you'll pay.
If you have asthma or breathing difficulties, your health care provider may recommend a medication called Montelukast. Montelukast isn't a particularly expensive medication, but the costs can mount up if you take more than one medication to control your symptoms or you need Montelukast long-term. Let's find out which Medicare plans cover Montelukast.
What Is Montelukast?
Montelukast is a medication commonly prescribed to prevent breathing difficulties in children and adults with asthma, such as wheezing or chest tightness. Alternatively, your doctor may prescribe this medication if you experience trouble breathing while exercising or have seasonal or nonseasonal rhinitis.
Health care providers often prescribe generic Montelukast, but it also comes as a branded medication called Singulair. It's available as tablets, chewable tablets and granules, and most people take one dose per day. Although Montelukast can help reduce asthma symptoms over time, it isn't suitable for treating an acute asthma attack.
Montelukast Side Effects
Montelukast can occasionally cause severe mental health problems, so it's only prescribed to treat rhinitis if other medications are ineffective. Other potential side effects include:
- Headache
- Acid reflux
- Stomach pain
- Diarrhea
- Tiredness
Does Medicare Cover Montelukast?
All Medicare Part D plans cover Montelukast. Original Medicare (Parts A and B) rarely covers prescription drugs, but you can purchase a supplementary Part D policy from a Medicare-approved private company to ensure coverage for Montelukast.
Alternatively, you may be eligible for Montelukast coverage as a Medicare Advantage enrollee. You can buy a Medicare Advantage plan from an approved private insurer instead of enrolling in regular Medicare.
Medicare Advantage benefits vary from provider to provider, although your plan must at least match the essential benefits covered by standard Medicare. However, most of the best Medicare Advantage plans also cover prescription medications. If your plan includes drug coverage, it will likely cover montelukast.
How Much Will I Pay for Montelukast With Medicare?
Fortunately, montelukast is relatively affordable, although how much you'll pay varies widely between pharmacies. Generally, montelukast costs in the region of $33 to $170 for 30 10-milligram tablets, and many people save money on their prescriptions by shopping around or using medication discount coupons.
You must pay for your prescription out of pocket until you satisfy your policy's annual deductible. Your deductible depends on which Medicare plan you have and your insurance company, although in 2024, you won't pay more than $545 if you have Medicare Part D (or $505 in 2023.)
Medicare co-pays for Montelukast are also inexpensive. Most Medicare insurers charge co-pays between $0 and $1 for this medication.
Montelukast Coverage Restrictions With Medicare
Your Medicare Part D or Medicare Advantage insurer is unlikely to impose coverage restrictions for Montelukast.
