Does Medicare Cover Zyvox?

In this article...
  • 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 its generic alternative. 

Basic Information About 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 and other 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. 

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