Does Medicare Cover Symbicort?

In this article...
  • Symbicort is prescribed for people with asthma that hasn't responded to other medications. Keep reading to learn more about Medicare coverage of this drug.Symbicort is prescribed for people with asthma that hasn't responded to other medications. Keep reading to learn more about Medicare coverage of this drug.

Symbicort contains two active ingredients, budesonide and formoterol. Budesonide reduces inflammation in the lungs, while formoterol relaxes the muscles in the airways. When combined, these two substances are helpful for treating asthma and chronic obstructive pulmonary disease. 

This guide explains how Symbicort is used and provides an overview of the Medicare coverage available for Symbicort.

Does Medicare Cover Symbicort?

Many Medicare Part D and Medicare Advantage plans cover Symbicort. In fact, Symbicort is covered for 90% of beneficiaries with a Medicare Advantage (Part C) prescription drug plan or a standalone Medicare Part D drug plan (PDP).1

Because Symbicort is a brand-name drug with no generic equivalent, it isn't covered by every plan. Medicare beneficiaries should check their plan's drug formulary to determine whether it's covered and how much they can expect to pay for it each month.

Are There Any Out-of-Pocket Costs for Symbicort?

The cost of Symbicort depends in part on whether you've already paid your deductible for the year. A deductible is the amount of money you must pay before your plan starts paying for prescription medications.

In 2022, the maximum deductible for any Medicare drug plan is $480. Once you've paid your deductible, you may need to pay a copay or co-insurance for each prescription you fill. The amount due depends on the type of plan you have and the amount of coverage available for Symbicort.

What Is Symbicort Prescribed For?

Symbicort is prescribed for patients with chronic obstructive pulmonary disease (COPD) and patients with asthma that isn't well-controlled by other asthma medications.

Some of the most common side effects of this medication include nasal irritation, sore throat, stomach pain, headaches and stuffy nose. It may take up to 2 weeks to see a noticeable difference in asthma or COPD symptoms, so it's important to continue taking Symbicort unless your doctor tells you to discontinue it.

Is Symbicort the Same as Albuterol?

Although Symbicort relaxes the muscles in the airways, it's not the same thing as albuterol. Symbicort is a maintenance inhaler that should be used daily, while albuterol is a rescue inhaler that's used only when someone has an asthma attack.

Both medications help people with respiratory problems, but Symbicort is used to prevent asthma and COPD symptoms, not to treat them once they've already occurred.

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