Medicare used to exclude Xanax from its prescription drug coverage. This changed when the Affordable Care Act (ACA) ruled that Medicare Part D should include coverage of Xanax and other medications within the same class.

Medicare Advantage plans that offer prescription drug benefits also include coverage of Xanax.

Copayments for the drug differ between the parts of Medicare and depend on various factors.

This article discusses the parts of Medicare that cover Xanax. Then, it describes Xanax, along with its side effects, warnings, and overdosage dangers.

Next, it compares the name brand with the generic form of the drug.

Lastly, it examines costs, as well as the programs that help people pay the costs.

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.

Extreme close-up image of a transparent yellow Xanax capsule pill. Tiny white balls can be seen through the capsule. If someone wonders, does Medicare cover Xanax?, this may be the pill to expect.Share on Pinterest
Douglas Sacha/Getty Images

Xanax coverage is available in different ways, depending on which part of Medicare the benefit is coming from.

Original Medicare

In 2013, the ACA ruled that Medicare Part D plans should include Xanax. Part D is the prescription drug coverage available to people who have original Medicare. Original Medicare comprises inpatient hospital insurance, Part A, and outpatient medical insurance, Part B.

If individuals with original Medicare receive Xanax during a hospital stay, Part A covers it, but if they need to take it at home, they will need either a Part D plan to receive coverage or a Medicare Advantage plan that includes prescription drug benefits.

Medicare Advantage

Medicare Advantage, Part C, is the alternative to original Medicare, and it provides parts A and B benefits. In addition, most Medicare Advantage plans offer prescription drug coverage, which includes Xanax or similar medications.

If people with a Medicare Advantage plan receive Xanax during a hospital stay, their plan covers it whether or not it includes prescription drug benefits.

However, if a person with a Medicare Advantage plan needs to take Xanax at home, their plan does not cover it unless it includes prescription drug benefits.

Medigap

Medigap is Medicare supplement insurance, which pays 50–100% of parts A and B out-of-pocket expenses. It does not include coverage of prescription drugs that a person takes in the home other than the limited number that Part B covers.

Xanax is a benzodiazepine, a drug that produces sedation and relieves muscles spasms, seizures, and anxiety. Benzodiazepines are only available with a prescription. Aside from Xanax, other common benzodiazapines include:

  • brand name Valium and its generic form diazepam
  • brand name Halcion and its generic form triazolam
  • brand name Ativan and its generic form lorazepam

Studies comparing Xanax to a placebo show it helps reduce anxiety and panic attacks, reports the Food and Drug Administration (FDA). The dosage range that doctors recommend is 0.75–4.0 milligrams (mg) per day.

According to a 2016 study, the number of adults filling benzodiazipine prescriptions had increased from 8.1 million to 13.5 million.

A person who experiences side effects from Xanax usually has them early in treatment, and they disappear upon continued use.

The most frequent include lightheadedness and drowsiness, but the medications may also cause:

Like other benzodiazepines, Xanax can cause tolerance. This means a person can, after a time, require a larger dose of the drug to get the same results.

It can happen even with short-term use and at the recommended dosages. However, the risk is higher at dosages in excess of 4 mg per day for periods longer than 12 weeks.

Dependence can result in withdrawal symptoms after someone suddenly stops taking the medication. Symptoms may include:

  • seizures
  • impaired concentration
  • muscle twitching
  • blurred vision
  • diarrhea

It is important to understand that Xanax slows down the central nervous system, which include the brain and spinal cord.

Because of this action, a person taking the drug should avoid driving or operating machinery while under its influence.

Overdosage is a serious danger of Xanax, as it can cause coma and loss of life. Symptoms of overdosage include:

  • diminished reflexes
  • impaired coordination
  • confusion
  • sleeping for unusually long periods
  • slow breathing

The risk of an overdose leading to loss of life is especially high when a person takes Xanax with other central nervous system depressants, such as:

  • alcohol
  • other benzodiazepines
  • opioids, which include pain relievers such as Vicodin and Oxycontin

It is dangerous for a person to take Xanax with any of the above medications, especially opioids. Taking Xanax with an opioid drug doubles the likelihood of slow breathing and death, notes a study in the Journal of Addictive Medicine.

The FDA says that approved generic drugs work in the same way as name brand drugs. This means Xanax and its generic form, alprazolam, have the same effectiveness, dosage form, strength, and safety.

All generic drugs must pass a rigorous review before the FDA approves them. Since the active ingredients in name brand and generic drugs are identical, they share the same risks and benefits.

The FDA also evaluates inactive ingredients of generic drugs to ensure they are acceptable.

If a person does not have prescription drug coverage, the cost of a Xanax prescription is approximately $32. For someone with either a Part D plan or a Medicare Advantage plan that includes medication coverage, the cost is much less. It depends on factors, such as:

  • whether the prescription is for the name brand or generic form
  • whether a person has met their annual deductible
  • the rules of the pharmacy that fills the prescription
  • the area of the country in which an individual resides

The below programs help someone with limited means pay Medicare costs for Xanax and other prescription drugs.

  • Extra Help assists in paying Part D costs for people with limited income and resources. It helps with about $5,000 of medication expenses per year.
  • Medicaid is a state-federal program that helps individuals with low-income pay healthcare costs.

Medicare covers Xanax and its generic form, as well as other drugs within the same class. Doctors use it to treat anxiety and panic disorder.

If a person has original Medicare, they must buy a Part D plan to receive coverage of a prescription to take at home.

Someone with a Medicare Advantage plan receives the coverage if their plan includes prescription drug benefits.