Reprexain Medicare Coverage


Does Medicare cover hydrocodone / ibuprofen?

62% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my hydrocodone / ibuprofen co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Donut Hole
Post-Donut Hole
Co-Pay Range
$45 – $406
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$5 – $406
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$10 – $406
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$5 – $406
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Reprexain

Here are some ways that may lower the cost of your hydrocodone / ibuprofen prescription.

Cheaper Alternative
Less expensive drugs that work the same way may be available.

Reprexain Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of hydrocodone / ibuprofen that may include:

Quantity Limits

Most Medicare plans restrict the amount of this prescription that can be purchased at one time. If you need to purchase a greater amount at one time, it may not be covered. Your options are to wait until that time period has passed before refilling, call your plan and ask for an exception, or consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is hydrocodone / ibuprofen typically on?

Tier 2

Medicare plans typically list hydrocodone / ibuprofen in Tier 2 of their formulary. Tier 2 means that this drug is a “non-preferred generic”. It will be expensive and there may be cheaper drugs that work in a similar fashion.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). If you encounter any issues, please let us know.
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