Does Medicare Cover Aimovig?

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As we age, our body’s ability to function at its optimum level declines, and we may need medical treatment to keep us healthy. Medicare is a government-funded health insurance program that covers medical expenses for people aged 65 or older and those with certain disabilities. One of the most common questions people have is whether Medicare covers Aimovig, a medication used to prevent migraines.

Aimovig has become a popular treatment option for people suffering from migraines, but the cost of the medication can be a concern. If you are a Medicare beneficiary, you may be wondering if Medicare covers Aimovig. In this article, we will explore the coverage options available under Medicare for Aimovig, so you can make an informed decision about your migraine treatment.

Does Medicare Cover Aimovig?

Does Medicare Cover Aimovig?

If you suffer from migraines, you may have heard about Aimovig, a medication that has been approved by the FDA to help prevent migraines. However, if you are a Medicare beneficiary, you may be wondering if Medicare covers Aimovig. In this article, we will explore the coverage options for Aimovig under Medicare.

What is Aimovig?

Aimovig (erenumab) is a prescription medication that is used to prevent migraines in adults. It is a type of medication called a calcitonin gene-related peptide (CGRP) inhibitor. Aimovig is self-administered through a monthly injection, and it works by blocking the activity of CGRP, a protein that is involved in migraines.

Medicare Part D Coverage for Aimovig

Medicare Part D is the prescription drug coverage portion of Medicare. If you are enrolled in Medicare Part D, you may be able to get coverage for Aimovig. However, coverage can vary depending on your specific plan. It is important to check with your Part D plan to see if Aimovig is covered and to understand any out-of-pocket costs you may incur.

What are the Costs of Aimovig under Medicare Part D?

The cost of Aimovig under Medicare Part D can vary depending on your specific plan. You may have to pay a deductible, copay, or coinsurance for the medication. It is important to check with your Part D plan to understand the costs associated with Aimovig.

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What are the Alternatives to Aimovig?

If Aimovig is not covered under your Medicare Part D plan, there are other medications available that may be covered. Some alternatives to Aimovig include:

– Emgality (galcanezumab)
– Ajovy (fremanezumab)
– Botox (onabotulinumtoxinA)

It is important to talk to your doctor about which medication may be right for you.

Medicare Part B Coverage for Aimovig

Medicare Part B is the medical insurance portion of Medicare that covers medically necessary services and supplies. Aimovig is not currently covered under Medicare Part B because it is a self-administered medication.

What are the Costs of Aimovig without Medicare Coverage?

Without Medicare coverage, Aimovig can be expensive. The cost of Aimovig can vary depending on the pharmacy and dose prescribed. However, it is important to note that there may be financial assistance programs available to help with the cost of Aimovig.

What are the Benefits of Aimovig?

The benefits of Aimovig include a reduction in the number of migraines experienced per month. In clinical trials, patients who took Aimovig experienced an average of 3-4 fewer migraines per month. Aimovig may also reduce the severity of migraines and improve quality of life.

Aimovig vs. Other Migraine Medications

Compared to other migraine medications, Aimovig has been shown to be more effective at preventing migraines. It is also the first medication in its class to be approved by the FDA. However, every individual is different, and it is important to talk to your doctor about which medication may be right for you.

Conclusion

If you are a Medicare beneficiary and suffer from migraines, Aimovig may be an option for you. While Medicare Part B does not currently cover Aimovig, Medicare Part D may provide coverage. It is important to check with your specific plan to understand the costs associated with Aimovig. Additionally, if Aimovig is not covered, there are other medications available that may be an alternative. As always, talk to your doctor about which medication may be right for you.

Freequently Asked Questions

Does Medicare Cover Aimovig?

Yes, Medicare covers Aimovig as a preventive treatment for migraines. Aimovig is a prescription medication that helps reduce the frequency of migraine attacks. It is administered through a self-injectable pen and is approved for use in adults. Medicare Part D plans cover Aimovig and other preventive migraine medications.

However, it is important to note that Medicare coverage for Aimovig may vary depending on the plan. Some Medicare Advantage plans may require prior authorization or have different copayments for Aimovig. It is important to check with your specific plan to understand the coverage and costs associated with Aimovig.

What is the Cost of Aimovig with Medicare?

The cost of Aimovig with Medicare varies depending on the specific plan. Medicare Part D plans cover Aimovig and other preventive migraine medications, but the cost may vary depending on the plan’s formulary and tier pricing. The out-of-pocket cost for Aimovig with Medicare can range from $0 to over $600 per month.

It is important to check with your specific Medicare plan to understand the coverage and cost of Aimovig. Additionally, there are patient assistance programs available for those who qualify, which can help reduce the cost of Aimovig for eligible individuals.

Is Prior Authorization Required for Aimovig with Medicare?

Some Medicare Part D plans may require prior authorization for Aimovig. Prior authorization is a process in which your healthcare provider must obtain approval from the insurance company before the medication is prescribed. This is to ensure that the medication is medically necessary and appropriate for the patient.

If your Medicare plan requires prior authorization for Aimovig, your healthcare provider will need to submit a request to the insurance company. The insurance company will review the request and determine whether or not to approve the medication. It is important to check with your specific plan to understand the prior authorization requirements for Aimovig.

What is the Dosage of Aimovig for Medicare Patients?

The recommended dosage of Aimovig for Medicare patients is 70 milligrams (mg) once a month. However, some patients may require a higher dosage of 140 mg once a month, which can be determined by a healthcare provider. Aimovig is administered through a self-injectable pen and should be injected subcutaneously in the abdomen, thigh, or upper arm.

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It is important to follow the dosage instructions provided by your healthcare provider and to use Aimovig as directed. If you have any questions or concerns about the dosage of Aimovig, it is important to speak with your healthcare provider.

Can Medicare Patients Get Assistance with the Administration of Aimovig?

Yes, Medicare patients can receive assistance with the administration of Aimovig. Aimovig is administered through a self-injectable pen, but patients may require assistance with the injection. Healthcare providers, family members, or caregivers can assist with the administration of Aimovig.

It is important to follow the administration instructions provided by your healthcare provider and to use sterile injection techniques. If you have any questions or concerns about the administration of Aimovig, it is important to speak with your healthcare provider.

Does Medicare Cover Prescription Medications?

In conclusion, Medicare coverage for Aimovig depends on several factors. While Aimovig is an FDA-approved medication for migraines, it is classified as a specialty drug and can be quite expensive. Medicare Part D prescription drug plans may cover Aimovig, but it depends on the specific plan and the tier level at which the drug is categorized.

It’s important to note that even if Aimovig is covered by Medicare, there may be out-of-pocket costs associated with the medication. These costs can vary depending on the individual’s plan and the specific pharmacy used to fill the prescription.

Ultimately, it is crucial for Medicare beneficiaries who are considering Aimovig to research their coverage options carefully and speak with their healthcare provider to determine if this medication is the right choice for their individual needs.

Introducing Roger Clayton, a healthcare maestro with two decades of unparalleled experience in medical insurance. As the visionary behind Medinscoverage, Roger's mission is to demystify the labyrinth of healthcare coverage, empowering individuals to make well-informed decisions about their well-being. His profound industry knowledge has been the cornerstone in crafting the website's exhaustive resources, offering users indispensable guidance and tools for their healthcare needs.

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