Does Medicare Cover Xiafaxan?
Fair Square Medicare

Does Medicare Cover Xiafaxan?

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By Daniel Petkevich

Jan 19, 2023

Get treatment for your IBS with Medicare

The symptoms of IBS don't have to come with getting older; some medications, like Xiafaxan, can help you live easier. And there's good news for Medicare beneficiaries. All Medicare Part D plans cover Xiafaxan, but the cost will depend on your coverage phase. Read on to see how much you can expect to pay for Xiafaxan.

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What is Xiafaxan and what does it do?

Xiafaxan is a prescription drug used to treat adults with traveler's diarrhea caused by E. coli and irritable bowel syndrome (IBS). It works by slowing down the movement of waste through the bowel, resulting in firmer stools and more frequent bowel movements. According to WebMD, it may also help you think more clearly by preventing a brain problem tied to liver disease. If you’re having trouble going to the bathroom regularly, Xiafaxan can help relieve these symptoms.

Does Medicare cover Xiafaxan?

If you have Medicare Part D, Xiafaxan is covered under your prescription drug plan. You should check with your insurance provider for specific details about what is covered and at what cost. You can also check your plan's formulary for more information.

How to get coverage for Xiafaxan through Medicare Part D?

If you are considering taking Xiafaxan, talk to your doctor first and make sure it is the best option for you. They will be able to answer any questions or concerns that you may have about this medication and its potential effects on other health conditions that you may have. Once you and your doctor have agreed to use Xiafaxan, there may be certain restrictions on coverage, including quantity limits or prior authorization requirements. You should always check with your insurer for specific details about what is covered and at what cost.

How much does Xiafaxan cost with Medicare?

The cost of Xiafaxan on Medicare will depend on your Part D prescription drug plan. Different plans may have different coverage levels and copay amounts, so it’s important to check with your insurer for specific details about what is covered and at what cost. Your costs on your Xiafaxan prescription also depend on your coverage phase. According to GoodRx, your cost in the post-deductible coverage phase could be $13-$57, and your cost in the coverage gap (aka donut hole) could be $22-$26.

Tips for getting the most out of your coverage for Xiafaxan

  • Talk to your doctor about any restrictions or prior authorization requirements before filling a prescription for Xiafaxan

  • Check with your insurer to find out what is covered and at what cost

  • Consider generic options if available

  • Ask your pharmacist if they have any discounts or coupons that could lower the cost of Xiafaxan

Questions to ask your doctor when considering taking Xiafaxan under Medicare Part D

  • Does Xiafaxan treat my condition?

  • Are there any side effects I should be aware of?

  • What is my copay?

  • What restrictions are in place on my coverage, if any?

  • Does my pharmacist have any coupons or discounts that I could use to lower the cost of Xiafaxan?

Takeaway

Medicare Part D covers Xiafaxan, a prescription drug used to treat adults with bowel trouble. Your exact coverage will depend on your plan, so it’s important to check with your insurer for specific details about what is covered and at what cost. Talk to your doctor about any restrictions with the prescription. This content is for informational purposes only. If you have questions about Medicare coverage or changing your plan, our team of experts is ready to help. Reach out to Fair Square Medicare today.

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


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