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.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Xanax coverage is available in various 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. It provides the same benefits as Part A and Part B. In addition, most Medicare Advantage plans offer prescription drug coverage, which includes Xanax or similar medications.
Medicare Advantage plans may also offer added benefits not covered by Original Medicare, such as vision, dental, and hearing.
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.
Read about Original Medicare vs. Medicare Advantage.
Medigap
Medigap is Medicare supplement insurance. It helps to cover gaps in coverage from Original Medicare. It helps pay for out-of-pocket expenses, such as copayments, deductibles, and coinsurance.
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 muscle spasms, seizures, and anxiety. Benzodiazepines are only available with a prescription.
Aside from Xanax, other common benzodiazepines include:
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.
Read about the effects and side effects of Xanax.
The
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.
Read more about brand-name vs. generic drugs.
If a person does not have prescription drug coverage, the cost of a Xanax prescription will be much higher than with a drug plan. For someone with either a Part D plan or a Medicare Advantage plan that includes medication coverage, the cost is much less.
However, 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
Medicare Part D also has its own premiums and deductibles that individuals have to pay. These vary by plan and provider.
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 $5,900 of medication expenses per year.
- Medicaid is a state-federal program that helps individuals with low incomes pay healthcare costs.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
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.