When it is medically necessary, Medicare usually covers Adderall under Part D. Part A may sometimes provide coverage. Depending on the type of plan, Medicare sometimes covers the generic form of Adderall.

Adderall is a prescription medication that doctors primarily use to treat attention deficit hyperactivity disorder (ADHD).

Some Medicare plans may offer coverage for Adderall, a brand name for amphetamine and dextroamphetamine. However, some plans may only cover the generic version.

Read on to learn about Medicare coverage options for Adderall. This article also looks at costs, the Extra Help program, and more.

Glossary of Medicare terms

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
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Usually, a stand-alone Medicare Part D plan covers Adderall.

Each Part D plan provides a list of the brand-name and generic drugs that it covers. This list is known as a formulary.

Part D plans may differ in terms of what their formulary includes, but Medicare dictates that each policy must cover at least two drugs in each of the most commonly prescribed categories.

Medicare plans sometimes cover the brand name drug Adderall. However, in other cases, an individual’s plan may only cover the generic version of the medication.

Part D is a prescription drug plan that those with Original Medicare can choose.

Private insurance companies that Medicare has approved administer Part D plans. A person’s specific plan might differ depending on the plan provider and where they live, as not all plans are available in all regions.

Each year, Medicare sends an Annual Notice of Change (ANOC) document that informs people about Medicare changes, including those affecting coverage. A person can check whether the plan provider has changed their formulary by adding or removing a drug, such as Adderall.

When a person has a Medicare Advantage plan, they cannot enroll in Part D. However, in 2024, 36 out of 43 Medicare Advantage plans will include prescription drug coverage, according to the Kaiser Family Foundation.

Original Medicare Part A occasionally provides coverage for Adderall. Medicare Part A covers inpatient hospital care, including the medication that someone receives while in the hospital.

Usually, Part A covers Adderall if someone takes it during their stay in the hospital or skilled nursing facility. Once the individual leaves the facility, Part A no longer covers the cost, and Part D will take over.

Learn more about Original Medicare.

For those with a Part D plan, the cost of Adderall may vary depending on the plan’s rules.

If a person does not have prescription drug coverage, they are responsible for the full cost of Adderall.

Depending on the Part D plan, coverage may only be available for the generic version.

Out-of-pocket expenses

The specific out-of-pocket expenses for Adderall may vary.

Along with a monthly premium, Part D plans may also have copayments that vary among plan providers.

Some Part D plans also have a deductible that a person must pay before their plan covers any costs. Deductible amounts may vary. In 2024, no Part D plan may have a deductible of more than $545.

A person can visit StreetRx for user-generated data on the recent costs of Adderall.

If a person with Medicare needs assistance with paying for prescription drugs, such as Adderall, they may qualify for the Extra Help program.

Extra Help covers some of the costs associated with Part D prescription drug coverage, such as:

  • deductibles
  • monthly Part D premiums
  • copayments

A person may automatically qualify for Extra Help if they:

  • receive both Medicare and Medicaid
  • have a Medicare savings program (MSP)
  • receive Supplemental Security Income

Those who qualify do not usually need to enroll. They should receive a notice from the Centers for Medicare and Medicaid Services letting them know that they are eligible.

If someone does not meet the eligibility requirements, they may qualify for Extra Help based on their income, as long as they have Medicare Part A and live in the United States.

According to the Social Security Administration, Extra Help is worth about $5,900 annually. Individuals can apply for Extra Help online or in person through their local Social Security office.

Adderall primarily treats ADHD.

However, doctors may sometimes prescribe it to treat narcolepsy, which involves an uncontrollable need for sudden deep sleep.

How does Adderall work?

Adderall affects the central nervous system by stimulating chemicals in the brain, such as dopamine and norepinephrine. These chemicals contribute to impulse control and hyperactivity, so Adderall may improve organization and concentration in some people.

Adderall contains two different drugs: dextroamphetamine and amphetamine. It is available as an oral tablet or an extended-release oral capsule.

The dosage for Adderall varies, but the medication is a controlled substance as it has the potential for addiction. Individuals taking Adderall should only take it as their doctor has prescribed.

Learn more about how Adderall works.

Medicare covers Adderall as long as the drug is medically necessary for a person’s health or well-being. In most cases, Part D prescription drug plans cover the cost of Adderall.

Depending on the plan, Medicare may only cover the generic version of Adderall. The costs of Part D plans differ, and the out-of-pocket expenses relating to Adderall may vary.

A person can contact Medicare to find out more about whether their specific plan covers Adderall.