Does Medicare Cover Metolazone?

Christian Worstell
In this article...
  • Discover whether Medicare Part D covers metolazone, a diuretic used to relieve edema in people with heart failure and kidney disease, including average co-pays.

Metolazone is a relatively inexpensive drug, but it can make a significant dent in your budget if you need to take it for a long period of time. Therefore, it's worth understanding whether your Medicare plan covers your medication. Below, we'll explore how Medicare coverage for metolazone works. 

What Is Metolazone?

Metolazone is a diuretic medication that reduces edema (fluid retention and swelling) and controls high blood pressure. Your doctor may prescribe Zaroxolyn, or the generic version Metolazone, if you have conditions that cause edema, such as heart failure or kidney problems

Several metolazone medications are available, including generic versions and branded products, such as Mykrox and Zaroxolyn. Most people require one tablet daily, and your doctor may start you on a low dose and increase the amount until you experience appropriate symptom relief. 

Metolazone Side Effects

There are a few side effects of Metolazone, which may worsen if you consume alcohol. These may include:

  • Dizziness
  • Headache
  • Muscle cramps
  • Sore or swollen joints
  • Constipation or diarrhea

Does Medicare Cover Metolazone?

Roughly 95% of Medicare Part D policies (supplemental prescription drug coverage) cover metolazone in some form. Some plans may only cover generic versions, while others may cover specific brands. 

The simplest way to determine which metolazone medications your policy covers is to check the formulary, a list of covered drugs separated into tiers. The higher the tier, the more expensive the drug. Branded and generic metolazone typically comes under Tier 2. If you can't find the brand prescribed by your doctor, consider asking them if a covered alternative is suitable. 

How Much Does Metolazone Cost With Medicare?

Most Medicare Part D plans include deductibles. Your deductible is the amount of money you must contribute toward your treatment before your coverage kicks in. Therefore, you'll pay for your medication out of pocket until you meet your deductible, which can't be more than $545 in 2024 or $505 in 2023

Fortunately, metolazone is a relatively inexpensive medication, costing around $65.07 for 30 2.5-milligram tablets. Discount coupons can help you purchase your prescription for less. 

Once your insurer begins covering your medication, you'll usually pay a nominal co-pay of $2 or less every time you receive coverage. However, some companies waive co-pays for metolazone altogether. 

Does Medicare Restrict Metolazone Coverage?

Your Medicare Part D plan is unlikely to restrict coverage for metolazone. Therefore, your insurer won't usually ask for a doctor's authorization or limit how much medication your pharmacist can fill per visit.

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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