Does Medicare Cover Inqovi?

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By Daniel Petkevich

Jan 11, 2023

Inqovi is covered on all Part D plans

Yes, all Medicare Part D prescription drug plans cover Inqovi. The amount you will pay depends on the coverage phase you are in. Read on for a rundown of Inqovi coverage on Medicare and how it affects your out-of-pocket costs for Inqovi.

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What is Inqovi?

Inqovi is a chemotherapy drug used to treat a variety of blood and bone marrow disorders, including leukemia. It works by blocking the growth of cancer cells and is taken as a pill once a day.

What Does Medicare Cover for Inqovi?

Medicare Part D covers Inqovi when it is medically necessary. This means that if your doctor or other health care provider prescribes this medication for you, Medicare Part D will help cover the cost in most cases.

How Much Does Medicare Pay for Inqovi?

Your out-of-pocket costs for Inqovi will depend on the tier according to your Part D plan and the coverage phase you are in.

Medicare Part D has four distinct coverage phases—initial deductible, initial coverage, gap (or donut hole) and catastrophic coverage—and each phase has different cost requirements and rules.

In the initial deductible phase, you are responsible for the entire cost of Inqovi until you reach your plan’s annual deductible, which may range from $1,436 - $1,804, depending on your plan.

Once you have met the deductible, you enter the initial coverage phase and pay a portion of the medication cost based on copay or coinsurance costs. Depending on the plan, this may range from $359-$1,716 per prescription.

If you reach a certain amount of total medication costs during the year, your plan enters the donut hole or coverage gap phase, and you are responsible for a higher portion of the cost until you hit catastrophic coverage.

In catastrophic coverage, your costs drop significantly, and you pay a small copay or coinsurance for each medication.

If you have questions about your coverage of Inqovi under Medicare Part D, contact your plan’s customer service team. They can help you understand what is covered and how much it will cost.

Eligibility Requirements for Coverage of Inqovi Under Medicare Part D

To be eligible for coverage of Inqovi under Medicare Part D, you must first enroll in a prescription drug plan. Then, you’ll need to meet all eligibility requirements set by the plan and have your doctor or other healthcare provider write a prescription for the medication.

If you’re enrolled in a Medicare Advantage plan, you may be eligible for coverage of Inqovi under your plan’s prescription drug benefit. Contact your plan’s customer service team to find out more about what is covered and how much it will cost.

Resources Available to Help with Questions or Concerns About Medicare Coverage of Inqovi

If you need to take Inqovi and want to ensure you’re in the most cost-effective plan, our Medicare experts are at your disposal. We will consider all of your healthcare and budgetary needs when making a recommendation. Give Fair Square Medicare a call today to talk through your options.

If you have questions or concerns about Medicare coverage of Inqovi, there are many resources available to help. The Centers for Medicare & Medicaid Services (CMS) is a good place to start and provides information on Medicare Part D plans as well as answers to frequently asked questions.

Takeaway

Medicare Part D prescription drug plans cover Inqovi when it is medically necessary. The amount you will pay depends on the coverage phase and your plan’s deductible, copayment, and coinsurance amounts. To find out more about what is covered and how much it will cost, contact your plan’s customer service team. For all your Medicare-related questions, reach out to a Medicare expert at Fair Square Medicare.

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