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Lagevrio Medicare coverage

Molnupiravir

Used for COVID-19

Lagevrio (molnupiravir) is an antiviral medication that was given Emergency Use Authorization (EUA) by the FDA in December 2021 to treat people with mild-to-moderate COVID-19. It's a capsule that's taken by mouth and a full course of treatment only lasts 5 days. Most people don't have many side effects with Lagevrio (molnupiravir). But possible side effects include diarrhea, nausea, and dizziness. Lastly, this medication doesn't have any known medication interactions.

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Price with GoodRx coupon

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$1202.13(Save 15.88%)
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$1011.18
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Medicare: Your GoodRx guide

Learn the ins and outs of Medicare with our comprehensive guide that covers eligibility, coverage, costs, and more.

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Common Medicare glossary terms
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Annual Notice of Change (ANOC):

The Medicare Annual Notice of Change (ANOC) is a letter for people enrolled in Medicare Advantage plans and anyone with Medicare Part D prescription coverage. People with Medicare Advantage or original Medicare (Part A and/or Part B) can have Part D plans. The ANOC informs enrollees about any changes to their benefits for the coming coverage year. By law, Medicare Advantage and Part D plans must send the ANOC to enrollees by September 30 — which is before the annual Medicare open enrollment period of October 15 to December 7. Even if you have the same plan, your benefits could change year to year.

Premium:

A premium is the cost of having a health insurance plan and is usually paid monthly. Medicare enrollees may pay several premiums. Most people don’t pay anything for Part A hospital insurance, but some people do depending on how long they worked and paid taxes. For outpatient and preventive coverage, the Part B standard premium is $185 a month in 2025, but people with higher incomes pay more. Your premium for Medicare Advantage plans will vary, but even so-called “zero premium” plans require you to pay your Part B premium. Part D premiums range in price, but the average is about $47 a month in 2025. If you have original Medicare and a Medigap supplement plan, you have an additional premium for that coverage.

Deductible:

A deductible is the amount you pay out of pocket before your Medicare plan begins cost-sharing. In 2025, the Part A deductible is $1,676 per benefit period. The Part B deductible is $257 for the year, but you can access certain preventive care — including some vaccines — without meeting your deductible. Medicare Advantage deductibles vary and your Part D deductible can’t exceed $590 in 2025.

Out-of-pocket limit:

Original Medicare has no annual out-of-pocket maximum. Medicare Advantage plans have out-of-pocket limits. In 2025, they are $9,350 for in-network covered services and $14,000 for in-network and out-of-network covered services combined.

Medicare Prescription Payment Plan:

Starting January 1, 2025, anyone with Part D coverage had the option to use the Medicare Prescription Payment Plan for their out-of-pocket medication costs instead of paying upfront at the pharmacy. This plan doesn’t provide savings, but allows you to spread prescription costs — including your deductible — over the year. Making payments can be particularly helpful for people who may skip or delay picking up prescriptions because of high costs early in the year. Also in 2025, the Part D out-of-pocket limit dropped to $2,000.

Initial coverage phase:

After a Medicare enrollee meets the Part D deductible (if the plan has one), the health insurance begins cost sharing. The initial coverage phase means you pay coinsurance or a copay for covered prescriptions.

Catastrophic phase:

When you reach the $2,000 out-of-pocket maximum, your Part D plan pays for 100% of covered medications for the rest of the year.

Medication ready
How to save on drugs with Medicare

Medicare Part D is the part of Medicare that helps cover prescription medications, including both brand name and generic. It also includes coverage for certain vaccines that aren’t covered by Part B, as well as some medical supplies.

Even with Medicare Part D coverage, you may still have out-of-pocket costs such as premiums, deductibles, copayments, and coinsurance. As of 2025, Medicare Part D plans include a $2,000 annual out-of-pocket cap. Once you reach this limit, your plan covers the full cost of your covered medications for the rest of the year.

Still, there are several ways to reduce your prescription medication cost. From GoodRx coupons to patient assistance programs, here are ways you can save money on the medications you need.

1. See if you qualify for Medicare’s Extra Help program

The Medicare Extra Help/Low-Income Subsidy program is a federally funded program for people covered under a Medicare Part D plan. It helps reduce enrollees’ out-of-pocket costs by limiting their deductibles and copays. To qualify, your income and assets fall below a certain limit.

If you’re eligible, you may receive:

  • No monthly premiums for Medicare Part D

  • No Medicare Part D deductible

  • Low copays for prescription medications

2. Use GoodRx coupons

You can’t combine GoodRx coupons with Medicare, but you can choose to use a coupon instead of your insurance if it results in a lower price.

Here’s how to download a GoodRx coupon:

  1. Go to the GoodRx website, or download the GoodRx app on your phone.

  2. Search for your prescription medication.

  3. Enter your prescribed dose and quantity, then set your location.

  4. Compare prices across different pharmacies in your area.

  5. Click “Find the lowest prices” or press “Enter.”

  6. You can have the coupon sent by text or email, or print it out.

  7. To apply the discount, show the coupon at the pharmacy when you fill your prescription. Ideally, this is done at drop-off before the prescription is filled.

3. Consider the Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan is a new program that can help make paying for medications more manageable. It’s open to anyone with a standalone Part D plan or those with Medicare Advantage plans that offer prescription medication coverage.

There is no cost to participate in the Medicare Prescription Payment Plan and participation is voluntary. Instead of paying for the total cost of your medications up front at the pharmacy, the payment plan allows you to spread the cost into smaller payments during the year. If you join, you will continue to pay your premium every month as well as an additional monthly amount on your payment plan. It’s a good idea to review how the Medicare Prescription Payment Plan works to determine if it’s right for you.

4. Compare Part D plans during open enrollment

Medicare open enrollment, which takes place every year from October 15 to December 7, is your chance to switch plans if another option offers better prescription medication coverage or lower costs. Plan costs and coverage details can change each year, so it’s important to review your options.

Here are some steps to help you compare plans:

  1. Make a list of all your medications and what dosages you take.

  2. Enter the names of your prescription medications to see which plans offer the best coverage.

  3. Look at premiums, deductibles, and medication costs for each plan. Plans usually change their formularies, premiums, and copays annually.

  4. Check if your preferred pharmacy is in each plan's network.

5. Get a 90-day supply

Opting for a 90-day supply instead of a monthly refill of your medication might help reduce your long-term out-of-pocket costs. Many insurance plans offer lower copays or bulk pricing for 3-month prescriptions.

If your medication is covered under your plan, see if your insurer’s mail-order or specialty pharmacy provides savings on a 90-day supply. If they do, ask your prescriber to write a prescription for a 90-day quantity to take advantage of these potential savings.

6. Ask about the generic version of your medication

Some medications have a generic version, and they generally cost less than the brand-name prescriptions. Generic medications are just as safe and effective as brand-name medications, so it’s an option worth considering to reduce your cost. Ask your prescriber about switching to a generic version of your medication to save money.

7. Consider lower-cost alternative medications

There may be other medications that help manage your condition, and they may cost less. If your medication is costly or not covered by your insurance, talk to your prescriber about lower-cost alternatives that might be a good option for you. Alternatives might have better insurance coverage or lower costs.

8. Learn more about patient assistance programs

Patient assistance programs (PAPs) offer free or low-cost medications to uninsured and low-income consumers. These programs, which primarily offer savings on brand-name medications, are usually run by private pharmaceutical companies or nonprofit organizations. You must meet certain qualifications and complete paperwork to receive savings from PAPs. However, some PAPs exclude Medicare recipients, so it’s important to review the program’s rules and requirements carefully.

9. Check state-funded resources

Depending on where you live, your state may offer programs to help you navigate prescription medication costs. A good place to start is your local Department of Aging. This U.S. Department of Health and Human Services office can help you find the best Medicare plan for the coverage you need.

Some states even have their own cost-saving programs for older adults. For example, Pennsylvania runs PACE and PACENET. These programs help eligible residents get prescription medications at reduced costs.

Alternatively, you can find out if your state has a State Pharmaceutical Assistance Program by using Medicare’s search tool. These programs are state-run and help qualifying residents pay for prescription medications.

10. Use a health savings account to pay for prescription medications

Although you can’t contribute to a health savings account (HSA) after enrolling in Medicare, you can still use any remaining funds in your account to pay for qualified medical expenses. An HSA allows you to use tax-free dollars to pay for eligible prescription medications. The money in your account does not expire so you can use your funds at any time to reduce your out-of-pocket medication costs.

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Frequently asked questions about Lagevrio

No, but Lagevrio was given Emergency Use Authorization (EUA) by the FDA to prevent serious illness during the COVID-19 outbreak. An EUA temporarily allows medications that didn't go through the traditional FDA approval process to be used during a public health emergency because there's an immediate need for the medication. Because Lagevrio can only be prescribed under EUA, your provider needs to go through a checklist to decide whether or not you qualify for this medication.

You're at a higher risk for severe COVID-19 illness if you're over 65 years old or have certain conditions, such as diabetes, obesity, kidney problems, heart problems, chronic obstructive pulmonary disease (COPD), or active cancer. Lagevrio is used to treat mild-to-moderate COVID-19 symptoms in people who have one or more of these risk factors. If you're not sure whether you have a risk factor for severe illness, talk to your healthcare provider.

Studies showed that taking Lagevrio lowers the risk of death or needing hospital care by 30% compared with placebo. People in the study had one or more risk factors for severe COVID-19 illness. And they started taking Lagevrio within 5 days of having mild-to-moderate COVID-19 symptoms. Keep in mind that the virus that causes COVID-19 can change over time, so this might affect how well Lagevrio works over time as well.

You take Lagevrio by mouth with or without food. Make sure to swallow the capsules whole. And keep in mind that it takes 4 capsules total (each with 200 mg of molnupiravir) to make up each full dose of Lagevrio. So you should be taking 4 capsules of Lagevrio twice daily for 5 days for a full treatment.

Lagevrio isn't recommended in pregnancy. Currently, there aren't enough studies done to understand how this medication affects human pregnancy, but animal studies show that it can cause birth defects. Because of this risk, your provider might ask you to take a pregnancy test before you start this medication. But in some cases, the benefits of using Lagevrio during pregnancy outweigh the risks. If you and your provider decide that this medication is appropriate during your pregnancy, you're highly encouraged to join the COVID-19 International Pregnancy Registry.

Lagevrio isn't recommended for people who are breastfeeding. Animal studies show that it can get into breastmilk. Because of the risk of possible harm to nursing babies, you should stop breastfeeding during treatment and for 4 days after the last dose of Lagevrio. If you're currently breastfeeding, you can consider pumping and throwing away the breast milk during this time. Ask your provider if you have any questions about breastfeeding with this medication.

No, Lagevrio and Paxlovid (nirmatrelvir / ritonavir) aren't the same. While they're both oral medications with EUA from the FDA to treat mild-to-moderate COVID-19, there are some key differences. (1) Paxlovid can be taken by children ages 12 and older, but Lagevrio can only be taken by adults ages 18 and older because of possible bone and cartilage damage in people who are younger. (2) Lagevrio should only be taken when there's no other FDA-authorized option for COVID-19, while Paxlovid doesn't have this recommendation. (3) Paxlovid can interact with many medications, whereas Lagevrio isn't currently known to have any interactions. To learn more, read this article about the differences between the two.