Does Medicare Cover Armour Thyroid?
- Find out whether Medicare will covers Armour Thyroid. Learn more about paying for this brand name medication for hypothyroidism and other thyroid problems.
The National Institute of Diabetes and Digestive and Kidney Diseases estimates that five out of every 100 Americans over the age of 12 suffers from hypothyroidism. If you're among them, the fatigue, weight gain, cold sensitivity, joint and muscle pain, thinning hair and other symptoms of the disease may get in the way of your quality of life. Fortunately, highly effective medications for hypothyroidism like Armour Thyroid are available. Understanding how and when Medicare pays for thyroid medications can help you and your doctor weigh your treatment options.
Does Medicare Cover Armour Thyroid?
Most Medicare Part D plans do not cover Armour Thyroid. If your plan does, the medication would be considered a Tier 3 or Tier 4 drug because it does not have a generic equivalent.
What Is a Medicare Formulary?
Medicare Part D is the portion of Medicare that typically pays for prescription medications. If you are eligible for any part of Medicare, you have the option to purchase a Medicare Part D plan through a private insurer. Laws require plans to cover the cost of medications for a variety of conditions, including hypothyroidism; however, insurers are permitted to prioritize certain treatments over others. As a result, Medicare Part D plans don't have to cover all medications for hypothyroidism. The Medicare Part D formulary tells you which drugs your specific plan covers.
Understanding Medicare Drug Tiers
A Medicare Part D plan categorizes drugs into five tiers:
- Tier 1 for the preferred generic drug, typically the least expensive option approved by the FDA
- Tier 2 for other generic drugs, which are usually slightly more expensive than the Tier 1 option
- Tier 3 for the preferred brand name drug, used for the least expensive brand name option for drugs that do not have generic equivalents
- Tier 4 for other brand name drugs, which are typically more expensive than the Tier 3 option
- Tier 5 for specialty and experimental drugs that may be unproven or require close monitoring
Your Medicare Part D plan uses this tier system to determine how much you must pay for your medications out of pocket. Higher tiers usually cost more than lower tiers.
How Can I Find Out If My Medicare Part D Plan Covers Armour Thyroid?
You can consult the formulary for your prescription drug coverage to find out if your plan will pay for Armour Thyroid.
How Much Will I Pay Out of Pocket for Armour Thyroid With Medicare Part D?
If your plan does not include Armour Thyroid in its formulary, you must pay for the entire cost of the drug out of pocket. Under a plan that does cover Armour Thyroid, the amount that you would pay out of pocket depends on where you are in your coverage as follows:
- Pre-deductible. Until you have paid your deductible, you will usually have to pay for the entire cost of the drug.
- Post-deductible. Once your deductible is met, your plan will pay for the drug, and you will likely only be responsible for a copay or coinsurance.
- Donut hole. After you have reached the donut hole for Medicare Part D coverage, you will usually be responsible for roughly 25% of the cost of your drug.
- Post donut hole. When your total prescription costs exceed the donut hole limit, you enter catastrophic coverage. Your insurance company will begin paying for the drug, and you will typically only have to pay a copay.
Donut hole levels vary from year to year. In 2021, the donut hole began at $4,130 and ended at $6,550.
How Much Does Armour Thyroid Cost?
GoodRx reports that the average retail cost for a 30-day supply of Armour Thyroid is $107.85. The cost varies, depending on where you live and choose to fill your prescriptions.
Do Any Medicare Drug Plans Cover Thyroid Medicine?
Yes, Medicare Part D plans must pay for at least one thyroid medicine. All of the plans surveyed by GoodRx covered the drug levothyroxine in October 2021. Brand-name versions of the medication were also covered by many plans.
What Is Armour Thyroid?
Armour Thyroid is a prescription medication that contains thyroxine (T4) and triiodothyronine (T3), two hormones that the thyroid produces. The thyroid glands of swine serve as the source for the hormones.
What Is Armour Thyroid Used to Treat?
Doctors prescribe Armour Thyroid for:
- Hypothyroidism, a disease where the thyroid does not produce sufficient levels of thyroid hormones
- Thyroid nodules and multinodular goiter, different types of lumps that form inside of the thyroid
- Hashimoto’s thyroiditis, a disorder where your immune system attacks your thyroid
- Some forms of thyroid cancer
How Does Armour Thyroid Work?
For people with hypothyroidism, Armour Thyroid works by increasing the body's supply of T3 and T4. The medication helps ensure you have an adequate supply of the hormones. By helping to normalize hormone levels, the drug diminishes symptoms of hypothyroidism.
What Is Generic for Armour Thyroid?
The generic form of Armour Thyroid is simply known as desiccated thyroid. As of October 2021, no generic equivalent of Armour Thyroid was approved for sale in the United States.
Is There a Substitute for Armour Thyroid?
Although you can't take a generic version of Armour Thyroid, other medications are available to treat hypothyroidism. Most often, doctors prescribe the drug levothyroxine. This medication works similarly to Armour Thyroid but uses synthetic hormones in place of T3 and T4 extracted from swine. Some brand names for levothyroxine include Levo-T and Synthroid.