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Istodax Medicare Coverage


Does Medicare cover Istodax?

81% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Istodax 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
$2833 – $3366
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
$42 – $3366
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$1019 – $3366
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
$142 – $3366
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 Istodax

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

Patient Assistance Program
Receive your prescription at no charge if you are eligible.
Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.

Find Your Istodax 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 kit (1 vial) of Istodax 10mg/vial

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $1227
AARP MedicareRx Saver Plus (PDP) $774
AARP MedicareRx Walgreens (PDP) $764
Aetna Medicare Rx Saver (PDP) $768
Anthem Blue Cross MedicareRx Plus (PDP) $993
Anthem MediBlue Essential (HMO) $907
CareMore Value Plus (HMO) $1678
Cigna-HealthSpring Preferred (HMO) $864
EnvisionRxPlus (PDP) $779
Express Scripts Medicare - Choice (PDP) $781
Express Scripts Medicare - Value (PDP) $751
First Health Part D Value Plus (PDP) $1014
Humana Enhanced (PDP) $950
Humana Preferred Rx Plan (PDP) $720
Humana Walmart Rx Plan (PDP) $720
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $42
MedicareBlue Rx Standard (PDP)Lower price available $3366
SilverScript Plus (PDP) $1044
Symphonix Value Rx (PDP) $773
TexanPlus Classic (HMO) $2471
Don't see your Medicare plan above?

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

Istodax Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Istodax 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 Istodax typically on?

Tier 5

Medicare plans typically list Istodax in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

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). They are accurate as-of January 2017 and the information may be updated. If you encounter any issues, please let us know.
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In all states except Tennessee, GoodRx is considered a marketer of prescription discount cards, and is not required to register as a discount card provider. In Tennessee, GoodRx is registered as a Prescription Drug Discount Plan Operator.
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