Does Medicare Cover Buspirone?

Buspirone reduces anxiety, so it's a common treatment for generalized anxiety disorder (GAD). It's especially useful for people who don't respond to selective serotonin reuptake inhibitors (SSRIs) and people who experience reduced libido and other sexual side effects while using SSRIs.

If your doctor prescribes buspirone, it's important to know whether it's covered by Medicare and how much you can expect to pay if it is. Here's what you need to know about buspirone Medicare coverage.

Information About Buspirone

Buspirone is FDA-approved for the treatment of generalized anxiety disorder and short-term relief of anxiety symptoms. It was originally developed as an antipsychotic, but pharmaceutical researchers discovered that it worked better as an antianxiety medication.

Is Buspirone a Good Medication for Anxiety?

Buspirone is considered a good medication for anxiety because it has fewer side effects than some of the other medications used to treat GAD. Another benefit of buspirone is that it isn't habit-forming like barbiturates and benzodiazepines. This is because buspirone doesn't affect the γ-Aminobutyric acid (GABA) receptors in the brain.

Medicare Coverage Rules for Buspirone

All Medicare prescription drug plans cover buspirone, increasing access to this important drug. Most plans include buspirone in Tier 1 of their formularies, limiting your out-of-pocket costs, even if you're in the Medicare donut hole or haven't met your deductible yet.

Depending on the terms of your plan, you may need to obtain prior authorization before Medicare covers the cost of buspirone. Your plan may also have other coverage requirements, such as trying another medication before you're approved for buspirone coverage.

How Much Does Buspirone Cost With Medicare?

The cost of buspirone depends on which Medicare plan you have and whether you've met your deductible yet. For 2024, the maximum Medicare prescription drug deductible is capped at $545. Some plans have deductibles of just a few dollars per year, so you may pay much less for your buspirone, even if you haven't met your deductible yet. Once you pay your deductible, you're in the co-pay stage. You'll have to pay a flat fee or a percentage of the cost for each prescription you fill.