Does Medicare Cover Timoptic?

In this article...
  • Timoptic is a type of eye drop used to reduce eye pressure in people with glaucoma. This guide explains whether Medicare covers Timoptic and other alternatives.

If you have glaucoma or another condition causing eye pressure, your doctor may prescribe Timoptic eye drops. Although Timoptic isn't the costliest medication, long-term use can become expensive. Therefore, it's worth checking whether your Medicare Part D plan covers Timoptic or similar drugs.

What Is Timoptic?

Timoptic is one of several branded medications containing timolol, which is a beta-blocker used to reduce eye pressure. It works by decreasing the amount of fluid inside the eye. 

The most common Timoptic dosage is a single drop in each affected eye twice daily. However, your doctor may recommend reducing your dose to one drop per day once you achieve a sustained reduction in eye pressure. 

Timoptic isn't suitable for people with lung problems, asthma or certain heart conditions. It can cause a temporary burning or stinging sensation immediately after use. Other potential side effects include:

  • Eye redness
  • Eye pain
  • Excessive tear production
  • Headache 
  • Dizziness
  • Crusty eyes

Does Medicare Cover Timoptic?

Timolol is covered by 97% of Medicare prescription drug coverage plans (Part D), but they won't necessarily cover the Timoptic brand. The easiest way to determine whether your plan covers Timoptic or an equivalent medication is to check the formulary, which is a comprehensive list of covered medications. You'll usually find timolol medications under Tier 4. 

If your plan doesn't cover Timoptic specifically, you could ask your doctor to prescribe generic timolol or a branded medication covered by your policy. Other branded medications containing timolol include Istalol and Betimol.

How Much Will I Pay for Timoptic With Medicare Part D?

A 5-milliliter bottle of Timoptic costs around $206.49 without insurance, and you'll usually need to cover the cost yourself until you meet your deductible. Insurers can set their

Medicare Part D deductibles up to a maximum of $480. However, your insurance company may cover certain prescription medications before you satisfy your deductible. 

After paying the deductible, your insurer will pay most of the costs of your medication. Most Part D insurers charge a co-pay of between $4 and $41 for Timoptic prescriptions. 

Are There Any Medicare Coverage Restrictions for Timoptic?

Most plans covering Timoptic don't impose coverage restrictions. However, rules can vary, so it's wise to check your policy's terms to determine whether there's a prior authorization requirement or quantity restriction. 

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