Does Medicare Cover Pravastatin?

Pravastatin is a medication that's typically prescribed for people with high cholesterol or who are at risk for heart problems. If you're taking pravastatin, and you have prescription drug coverage through Medicare, there's good news — 100% of Medicare drug plans cover the medication. Your specific costs can vary based on the plan you choose, so it's helpful to understand how coverage works. 

What Is Pravastatin?

Pravastatin is a drug that reduces the levels of cholesterol and triglycerides in your body. Your doctor may prescribe it to slow the rate of atherosclerosis, a condition that happens when your arteries thicken or harden due to the buildup of plaque. In some cases, you may use pravastatin if you have heart disease; it can help reduce the need for surgery.

If you receive a prescription for pravastatin, your doctor will likely recommend that you modify your diet and fitness routine as well. Used in combination with lifestyle changes, the medication can help reduce your risk of a stroke, heart attack, angina or heart disease.

Pravastatin is an HMG-CoA reductase inhibitor. When you take this medication, it prevents your body from making a key enzyme in the cholesterol-production process. As a result, you create cholesterol at a slower rate, which helps reduce plaque buildup. When your arteries aren't blocked, your blood can flow freely.

How Much Does Pravastatin Cost if You Have Medicare?

If you have a Medicare Part D prescription drug plan or a Medicare Advantage plan that covers prescriptions, your pravastatin is covered. However, the price you pay depends on a number of factors.

To start, look at your deductible. If you haven't met it yet, you'll pay full price for pravastatin. This cost can vary based on where you live and the pharmacy you choose; some pharmacies offer lower prices, so it pays to shop around. Deductibles are different from plan to plan, but they can't be more than $480 in 2022.

After your prescription drug costs have surpassed your deductible, your plan starts to pay. Every time you fill a prescription, you'll pay a co-pay. This could be a flat fee or a percentage of the drug cost. Co-pays usually vary based on how the insurance company classifies the drug; pravastatin is typically a Tier 1 drug, which means that it's among the most affordable options. You can find the specific co-pay for pravastatin in the drug formulary for your plan.

Are There Any Medicare Coverage Restrictions for Pravastatin?

In most cases, Medicare prescription drug plans restrict the number of pravastatin tablets you can get at a time. This limit is usually set to a 1-month supply, which means you'll need to refill the prescription every month.