Is Aimovig Covered By Medicare?

Are you suffering from migraines and wondering if your Medicare plan covers Aimovig? You’re not alone. Aimovig is a new drug that has been approved by the FDA to help prevent migraines, but navigating insurance coverage can be confusing. In this article, we will explore whether Aimovig is covered by Medicare and what you need to know about the process. So, let’s dive in!

Is Aimovig Covered by Medicare?

Understanding Aimovig

Aimovig is a medication used to prevent migraines in adults. It is a self-injectable medication that is administered once a month. Aimovig is classified as a calcitonin gene-related peptide (CGRP) receptor antagonist and is designed to block the activity of CGRP, a protein that is believed to play a key role in migraines.

Aimovig has been shown to be effective in reducing the frequency and severity of migraines in clinical trials. It is available by prescription only and is typically covered by most insurance plans.

Medicare Coverage for Aimovig

Medicare is a federal health insurance program that provides coverage for individuals who are 65 years of age or older, as well as individuals with certain disabilities or chronic conditions. Medicare is divided into several parts, including Part A, which covers hospital stays, and Part B, which covers doctor visits and other outpatient services.

Currently, Medicare Part B does not cover Aimovig or any other CGRP antagonists for the treatment of migraines. This means that if you have Medicare and you are prescribed Aimovig, you will be responsible for paying for the medication out of pocket.

Alternative Options for Medicare Beneficiaries

If you have Medicare and are looking for an alternative option for the treatment of migraines, there are several options available. These include:

• Triptans: These are a class of medications that are used to treat migraines. They work by constricting blood vessels in the brain and reducing inflammation. Triptans are available in both pill and injection form.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These are pain relievers that are commonly used to treat headaches. They work by reducing inflammation and pain in the body. NSAIDs are available over the counter and by prescription.
• Antidepressants: Some types of antidepressants have been shown to be effective in preventing migraines. They work by altering the levels of certain chemicals in the brain that are believed to play a role in migraines.

It is important to talk to your doctor about which treatment option is right for you.

Cost of Aimovig

As mentioned earlier, if you have Medicare and are prescribed Aimovig, you will be responsible for paying for the medication out of pocket. The cost of Aimovig can vary depending on several factors, including your insurance coverage and the pharmacy you use.

According to GoodRx, the average cost of Aimovig without insurance is around $700 per month. However, some pharmacies may offer discounts or coupons that can help reduce the cost of the medication.

Conclusion

Aimovig is an effective medication for the prevention of migraines, but unfortunately, it is not currently covered by Medicare Part B. If you have Medicare and are looking for an alternative treatment option, there are several options available, including triptans, NSAIDs, and antidepressants. It is important to talk to your doctor about which treatment option is right for you.

Frequently Asked Questions

1. Is Aimovig covered by Medicare?

Yes, Aimovig is covered by Medicare. However, the coverage may vary depending on the type of Medicare plan you have. Medicare Part D plans cover prescription drugs, including Aimovig, but the coverage and cost-sharing arrangements differ from plan to plan. Some Medicare Advantage plans also cover Aimovig, but the coverage and cost-sharing arrangements may be different from those of Original Medicare.

It is important to check with your Medicare plan provider to understand what your plan covers and how much you will be responsible for paying out-of-pocket for Aimovig. In some cases, you may need to get prior authorization from your plan provider before your Aimovig prescription is covered.

2. What is Aimovig used for?

Aimovig is a prescription medication used to prevent migraines in adults. It is a type of medication called a calcitonin gene-related peptide (CGRP) inhibitor, which works by blocking the action of CGRP, a protein that is involved in the development of migraines. Aimovig is typically used by people who have frequent or severe migraines that have not been effectively managed with other medications.

Aimovig is not used to treat an active migraine attack, but rather to prevent future attacks. It is given as a subcutaneous injection once a month and is available in two doses: 70 mg and 140 mg.

3. How effective is Aimovig?

Aimovig has been shown to be effective in reducing the frequency and severity of migraines in clinical trials. In one study, people who took Aimovig had, on average, three fewer migraine days per month compared to those who took a placebo. In another study, about 50% of people who took Aimovig had their number of migraine days reduced by at least half, compared to 27% of people who took a placebo.

However, not everyone who takes Aimovig will experience the same level of effectiveness. It may take several weeks or months of treatment to determine whether Aimovig is effective for an individual person, and some people may need to try other medications or treatments if Aimovig is not effective or causes side effects.

4. What are the side effects of Aimovig?

Like all medications, Aimovig can cause side effects. The most common side effects reported in clinical trials include injection site reactions, such as pain, redness, or swelling at the injection site. Other possible side effects include constipation, muscle cramps, and itching.

While serious side effects are rare, some people may experience allergic reactions, such as difficulty breathing or swelling of the face, lips, tongue, or throat. If you experience any unusual or severe side effects while taking Aimovig, you should contact your healthcare provider immediately.

5. How do I get Aimovig?

Aimovig is a prescription medication that can only be obtained with a prescription from a healthcare provider. If you are interested in trying Aimovig, you should talk to your healthcare provider about whether it is a good option for you. Your healthcare provider will evaluate your medical history and symptoms to determine whether Aimovig is appropriate and will provide you with a prescription if it is.

Once you have a prescription for Aimovig, you can obtain it from a pharmacy. Depending on your insurance coverage, you may be responsible for paying a portion of the cost of Aimovig. However, some insurance plans may cover the full cost or offer copay assistance programs to help offset the cost. Be sure to check with your insurance provider to understand what your plan covers and what your out-of-pocket costs will be.

Medications Not Covered by Medicare

In conclusion, Aimovig is a relatively new drug that has shown promising results in treating migraines. However, the coverage of Aimovig by Medicare is still uncertain. While some Medicare plans may cover Aimovig, others may not. It is important to check with your Medicare provider to find out if Aimovig is covered under your plan.

If Aimovig is not covered by your Medicare plan, there may be other options available. Speak with your healthcare provider to discuss alternative treatments or medications that may be covered by Medicare. Additionally, you may want to look into patient assistance programs or discounts offered by the manufacturer of Aimovig.

Overall, while the coverage of Aimovig by Medicare may be unclear, there are still options available for those who suffer from migraines. It is important to explore all available options and work with your healthcare provider to find the best treatment plan for you.