Does Medicare Cover Zyvox?

Christian Worstell | January 03, 2024

Zyvox is an antibiotic prescribed to treat severe infections. Discover when Medicare may cover Zyvox or a generic, and learn about the costs of treatment.

Zyvox is an antibiotic that can be essential when treating infections that are resistant to more common antibiotics. Luckily, all Medicare drug plans cover this medication or the Zyvox generic alternative.

What is Zyvox?

Zyvox is a brand name for the drug linezolid. This drug is a powerful antibiotic that doctors use to treat pneumonia and skin infections resistant to treatment by other antibiotics. Linezolid may be prescribed for conditions such as pneumonia, MRSA and certain tuberculosis infections.

Doctors avoid using it for mild infections that other antibiotics can treat. This practice helps maintain linezolid as an effective treatment for severe and antibiotic-resistant infections. People taking Zyvox should finish the entire prescription to avoid reducing the effectiveness of the antibiotic.

The drug is effective against infections caused by Gram-positive bacteria. Zyvox antibiotics aren't effective against viruses, such as influenza.

Medicare Coverage for Zyvox

Zyvox and its generic alternatives are covered by Medicare Part D and Medicare Advantage plans. Depending on your plan and deductible, your co-pay may range from $1 to $112. Most plans categorize Zyvox as a tier 4 drug, meaning it can be more expensive than many other medicines. Your co-pay may be lower if you've met your deductible or reached the catastrophic coverage phase.

Some plans place a quantity restriction on Zyvox. This limitation means beneficiaries can only get a certain amount of medicine at once.

Because Zyvox is used to treat severe infections, doctors often administer the drug intravenously in an inpatient setting. People who need Zyvox may be too sick to go home, and doctors reserve this medicine for the most severe infections. Medicare Part B covers Zyvox when it's used in the hospital.

How Much Does Zyvox Cost Without Coverage?

A prescription for Zyvox can cost up to $2,655 at a regular retail pharmacy. Prescription discount plans can reduce the price, but you'll usually pay less by using your Medicare coverage.

About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. 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 Mike@MyHelpAdvisor.com.