Does Medicare Cover Reglan?
- Reglan treats slow stomach emptying in people with diabetes and can help reduce the heartburn associated with GERD. Learn whether Medicare covers Reglan.
Purchasing a Medicare Part D plan can reduce how much you spend out of pocket on prescription medications. If your doctor prescribes Reglan, you'll want to know whether your healthcare insurance covers your treatment. This article explores whether Medicare covers Reglan.
What Is Reglan?
Reglan, also known as metoclopramide, is a medication used to treat gastroparesis in people with diabetes. Gastroparesis is slow stomach emptying and can cause various symptoms, such as heartburn, nausea and uncomfortable fullness. Doctors may also prescribe this medication to ease the symptoms of gastroesophageal reflux disease (GERD) because it stimulates stomach and digestive tract movements to reduce heartburn.
This medication is only available with a doctor's prescription and comes as oral tablets, water-soluble tablets or a liquid suspension. Reglan can cause side effects, including:
- Feelings of weakness or low energy
- Sore muscles
Generally, you should take Reglan on an empty stomach at least half an hour before eating or going to bed. Most people take Reglan four times daily, although your doctor may recommend a different schedule. You should always take your medication exactly as instructed by your healthcare provider.
Does Medicare Cover Reglan?
Fortunately, all Medicare prescription drug plans (Medicare Part D) cover metoclopramide. However, your policy may not cover Reglan specifically, as it is a brand of metoclopramide.
You can check your policy's formulary to determine whether it includes Reglan. The formulary is your insurer's list of covered medications, and most companies list metoclopramide under Tier 1. If your plan doesn't cover Reglan, consider asking your doctor to prescribe an alternative brand or generic metoclopramide.
How Much Does Reglan Cost With Medicare?
You must usually meet your Part D deductible before your insurer pays for prescription medications, including Reglan. Deductibles vary by provider, but they can't exceed $480 as of 2022. However, your policy may cover certain medications in the period before you meet the deductible, known as the deductible stage.
Generally, you're responsible for paying the full cost of your Reglan prescription during the deductible stage. Expect to pay around $9.17 for 30 10-milligram tablets.
The post-deductible stage begins after you've paid your annual deductible. Your insurer then starts paying for your medication, although you'll sometimes need to pay a small co-pay out of pocket. Many insurers don't charge co-pays for Reglan, and those that do usually charge $1 or less.
Does Medicare Restrict Reglan Coverage?
Reglan is a relatively inexpensive medication, so most Medicare Part D plans don't restrict coverage. However, some companies may require pre-authorization, which means your doctor must notify the insurer that your medication is medically necessary.