Fair Square Medicare Wordmark

Does Medicare Cover Qutenza?

woman sitting on sofa feeling pain in her foot at home stock photo
By Daniel Petkevich
Jan 13, 2023

Read this before seeking treatment

Regardless of your ailments or your Medicare plan, no one should have to go through life in pain. Qutenza is an option for those seeking topical relief from nerve pain. Unfortunately, the cost for Qutenza can be about $987 according to

GoodRx

, since most Medicare Part D plans do not cover this medication. Read on to see some options for alternate treatments or payments.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Overview of Qutenza and its uses

Qutenza is a prescription topical and transdermal patch-based medication used to manage pain associated with postherpetic neuralgia, diabetic neuropathy of the feet, and peripheral neuropathic pain due to a variety of conditions. It contains 8% capsaicin and helps reduce the intensity of intermittent burning and shooting pains.
For those who have Medicare Part D, coverage of Qutenza is unlikely. However, you may be able to get reimbursement if your doctor prescribes the drug and your pharmacy accepts Medicare. You should contact your plan administrator for more information.
If you do not have Medicare Part D or don't qualify for reimbursement, you may still be able to find financial assistance programs that can help make Qutenza more affordable. For example, there are patient assistance programs available through the manufacturer of Qutenza and other organizations that may provide discounts or financial aid. You can also ask your doctor if they offer any payment plans or if they have samples of the drug to give you.

How Medicare Part D works and what it covers

Medicare Part D

is a federal program that subsidizes the cost of prescription drugs. It is offered through private insurance companies and helps beneficiaries pay for their medications. Part D plans cover both brand name and generic drugs, but they do not typically cover Qutenza or other non-traditional medications, such as topical or transdermal patches.

What is not covered by Medicare Part D, including Qutenza

Medicare Part D does not typically cover Qutenza, as it is a non-traditional medication. Other medications and treatments not covered by Part D include over-the-counter drugs, herbal remedies, vitamins and supplements, cosmetic procedures, experimental treatments or drugs. There might be some pain relief prescriptions that will be approved on your Part D plan. Consult with your doctor about finding an appropriate substitute for Qutenza, and check your Part D formulary to see what be covered. The above does not constitute medical advice; this content is for informational purposes only.

Other ways to pay for Qutenza if you don’t have insurance coverage

If you don’t have insurance coverage for Qutenza, there are still some options to help make the drug more affordable. Talk to your doctor about any payment plans or samples they might offer. Additionally, you can look into patient assistance programs offered through the manufacturer of Qutenza and other organizations that may provide discounts or financial aid.

Common questions about the cost of Qutenza and other treatments for chronic pain relief

When considering the cost of Qutenza or other treatments for chronic pain relief, it’s important to do your research and talk to your doctor about the best option for you. Some questions Medicare beneficiaries might have about Qutenza include the following:
  • Will Medicare Part D help cover the cost of Qutenza?
  • What if I don’t have Medicare Part D or don’t qualify for reimbursement?
  • Are there any financial assistance programs available to help cover the cost of Qutenza?
  • Does any other insurance plan cover Qutenza?
To answer these, you might consult with your doctor, pharmacist, or insurance plan provider. You may find that there are more affordable alternatives than Qutenza, such as over-the-counter medications or lifestyle changes. Be sure to speak with your doctor about any concerns regarding the treatments for chronic pain relief.

Takeaway

Medicare Part D plans do not generally cover Qutenza. However, you may be able to get reimbursement if your doctor prescribes the drug and your pharmacy accepts Medicare. Additionally, there are patient assistance programs available through the manufacturer of Qutenza and other organizations that may provide discounts or financial aid. Be sure to do your research and talk to your doctor about the best option for you. This content is for informational purposes only. It does not constitute medical advice and should not be used as a substitute for professional medical advice. If you have questions about Medicare, talk to an expert at

Fair Square

today.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

air purifier stock image
Does Medicare Cover Air Purifiers?
Nov 18, 2022
heart surgery stock image
How Much Does Open Heart Surgery Cost with Medicare?
Jan 27, 2023
Sinusitis. stock illustration
Is Balloon Sinuplasty Covered by Medicare?
Dec 1, 2022
stair lift stock photo
Does Medicare Cover Stair Lifts?
Nov 18, 2022
Health insurance form on a table with pen, calculator and glasses stock image
What You Need to Know About Creditable Coverage
Jan 18, 2023
senior gentleman wearing a suit working on his laptop outside of his office stock photo
How Your Employer Insurance and Medicare Work Together
Sep 27, 2022
Union Station in Denver stock image
15 Best Ways for Seniors to Stay Active in Denver
Mar 9, 2023
Doctor talking to patients are explaining the treatment of a patient's illness stock photo
How Much Does Rexulti Cost with Medicare?
Jan 24, 2023
woman sitting on sofa feeling pain in her foot at home stock photo
Does Medicare Cover Qutenza?
Jan 13, 2023
Cover image
The Fair Square Bulletin: July 2023
Jul 17, 2023
The feet of a person suffering from foot pain stock photo
Does Medicare Cover Cartiva Implants?
Nov 29, 2022
Cover image
The Fair Square Bulletin: June 2023
Jun 30, 2023
a variety of pills in a daily pill organizer stock image
Does Medicare Cover Vitamins?
Dec 5, 2022
Cover image
The Easiest Call You'll Ever Make
Jun 28, 2023
Cover image
Is Fair Square Medicare Legitimate?
Jul 27, 2023
Physiotherapist showing workout record on exercise bike
Does Medicare Cover Exercise Physiology?
Jan 11, 2023
Cover image
Health Savings Accounts (HSAs) and Medicare
Apr 24, 2023
Illustrated representation of medical marijuana, using a prescription bottle with a marijuana leaf on the front.
Does Medicare Cover Medical Marijuana?
Jan 6, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Jacksonville

13 Best Ways for Seniors to Stay Active in Phoenix

14 Best Ways for Seniors to Stay Active in Nashville

14 Best Ways for Seniors to Stay Active in Washington, D.C.

20 Questions to Ask Your Medicare Agent

Can I Have Two Primary Care Physicians?

Can I Laminate My Medicare Card?

Can I Use Medicare Part D at Any Pharmacy?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Can Medicare Help with the Cost of Tyrvaya?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Cosmetic Surgery?

Does Medicare Cover COVID Tests?

Does Medicare Cover Diabetic Eye Exams?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Hoarding Cleanup?

Does Medicare Cover Inqovi?

Does Medicare Cover Jakafi?

Does Medicare Cover Krystexxa?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Macular Degeneration?

Does Medicare Cover Mental Health?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Oxybutynin?

Does Medicare Cover Service Animals?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover SIBO Testing?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Tymlos?

Does Medicare Pay for Allergy Shots?

Does Medicare pay for Opdivo?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Explaining the Different Enrollment Periods for Medicare

How Can I Get a Replacement Medicare Card?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Much Does Medicare Part B Cost in 2023?

How Much Does Trelegy Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How to Apply for Medicare?

How to Choose a Medigap Plan

Is Displacement Affecting Your Medicare Coverage?

Is Emsella Covered by Medicare?

Is PAE Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare 101

Medicare Guaranteed Issue Rights by State

Medicare Supplement Plans for Low-Income Seniors

Medigap vs. Medicare Advantage

Should You Work With A Remote Medicare Agent?

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: September 2023

What Does Medicare Cover for Stroke Patients?

What Happens to Unused Medicare Set-Aside Funds?

What Is a Medicare Advantage POS Plan?

What Is Medical Underwriting for Medigap?

What to Do When Your Doctor Doesn't Take Medicare

What's the Deal with Flex Cards?

When Can You Change Medicare Supplement Plans?

When to Choose Medicare Advantage over Medicare Supplement

Which Medigap Policies Provide Coverage for Long-Term Care?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M