Does Medicare Cover Oxybutynin?

Christian Worstell
In this article...
  • Oxybutynin can reduce symptoms such as frequent urination in people with overactive bladders. This guide explains Medicare Part D coverage for oxybutynin.

If you have an overactive bladder, finding an effective treatment can help you manage your symptoms and enjoy an unrestricted lifestyle. Planning how to pay for your medication provides peace of mind, so it's worth understanding how Medicare coverage for oxybutynin works.

What Is Oxybutynin?

Oxybutynin helps reduce the symptoms of an overactive bladder, such as incontinence or frequent urination. It's a type of antispasmodic drug that works by reducing smooth muscle contractions in the bladder. The medication comes as a tablet, extended-release tablet or syrup.  

Doctors may prescribe oxybutynin to adults and children aged 6 or older. Most adults begin with an oxybutynin dose of 5 or 10 mg per day on an empty stomach, although you may require up to 30 mg if your symptoms are severe. Your doctor will tailor your dosage to your needs, so you should defer to their instructions if they differ from the guidelines on the packaging. 

Oxybutynin Side Effects

Some people develop eye pain or hives while taking oxybutynin — you should contact your doctor if you experience either of these symptoms. The following side effects of oxybutynin require urgent medical attention:

  • Confusion
  • Seizures
  • Fever
  • Abnormal heartbeat
  • Hallucinations
  • Breathing difficulties
  • Facial redness
  • Extreme drowsiness
  • Fainting

Does Medicare Cover Oxybutynin?

Original Medicare is unlikely to cover self-administered medications. However, practically all Medicare Part D plans cover oxybutynin. You can confirm whether your plan covers your medication by checking the list of covered drugs (formulary) — you'll usually find oxybutynin within Tier 2. The medication may appear under the brand names Ditropan or Ditropan XL.

How Much Does Oxybutynin Cost With Medicare?

Medicare Part D enrollees must pay for their own medication until they meet their deductible unless they have a deductible-free plan. Providers cannot charge Part D deductibles higher than $545 in 2024, rising from $505 in 2023. 

The cost is $45.35 on average for 90 Oxybutynin 5 mg tablets, making it a relatively inexpensive drug. However, some pharmacies may charge more or less than this average, so it's worth shopping around to find the best deals. Some people also subscribe to a prescription discount service to obtain vouchers for money off oxybutynin.

Once you've satisfied your deductible, your insurance coverage begins. Many insurers cover the entire cost of oxybutynin without charging enrollees a co-pay when they fill a prescription. However, your insurer may ask you to contribute a modest co-pay, which is unlikely to exceed $1. 

Does Medicare Restrict Coverage for Oxybutynin?

Medicare coverage restrictions for oxybutynin are relatively unusual. Therefore, you're unlikely to need prior authorization from a healthcare provider. Insurers don't typically limit how much oxybutynin you can receive at a time.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at

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