Specialty Drug

Ganciclovir

GANCICLOVIR is an antiviral medicine. It is used to treat or prevent infections caused by certain kinds of viruses. It is commonly used to treat and prevent cytomegalovirus (CMV) infections of the eye or body. Compare CMV nucleoside analogues.

Cytovene Medicare Coverage

Overview

Does Medicare cover ganciclovir?

Yes.
100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my ganciclovir co-pay with Medicare?

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

Deductible
Typical
Donut Hole
Post-Donut Hole
Co-Pay Range
$1227 – $2163
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
$2 – $1040
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$7 – $1254
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 – $108
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 Cytovene

Here are some ways that may lower the cost of your ganciclovir prescription.

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

Find Your Cytovene Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 1 vial (10ml) of ganciclovir 500mg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $97
AARP MedicareComplete Plan 1 (HMO) $95
AARP MedicareComplete SecureHorizons (HMO) $98
AARP MedicareRx Preferred (PDP)Lower price available $747
AARP MedicareRx Saver Plus (PDP) $547
Aetna Medicare Rx Saver (PDP) $2
Cigna-HealthSpring Preferred (HMO) $91
Cigna-HealthSpring Rx Secure (PDP)Lower price available $869
Cigna-HealthSpring Rx Secure-Extra (PDP)Lower price available $768
EnvisionRxPlus Silver (PDP) $462
Express Scripts Medicare - Value (PDP)Lower price available $955
First Health Part D Value Plus (PDP) $7
Humana Enhanced (PDP)Lower price available $913
Humana Preferred Rx Plan (PDP)Lower price available $726
Humana Walmart Rx Plan (PDP)Lower price available $726
Kaiser Permanente Senior Advantage (HMO) $10
MedicareBlue Rx Standard (PDP) $365
SilverScript Choice (PDP) $53
Symphonix Value Rx (PDP)Lower price available $635
WellCare Classic (PDP) $47
Don't see your Medicare plan above?

Find and configure your plan to see exact co-pay prices for your meds.

Cytovene Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of ganciclovir that may include:

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is ganciclovir typically on?

Tier 2

Medicare plans typically list ganciclovir 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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