medicare & klonopin

Discussion in 'Fibromyalgia Main Forum' started by romalaw, Aug 18, 2009.

  1. romalaw

    romalaw Member

    Because I fortunately won my disability appeal last year, I am now on medicare. I recently learned that klonopin (along with all the drugs classified as benzodiazapens(sp) are not covered by medicare part B. The brand name is $60 a month. I discovered, as Cheney states, that the generic doesn't work as well for those of us with CFIDS.

    Anyway, there is an appeal process and I intend to appeal. Just wondered if anyone had ever appealed this drug with medicare and won?

  2. 3gs

    3gs New Member

    are you sure its not the plan you picked?

    I have medicare and am on a benzo and its covered. Lots on the board take them and no one has ever said anything about this.

    Is this something new?
  3. romalaw

    romalaw Member

    I am on medicare advantage, my husband's retirement health care coverage. I spoke with the pharmacist today who confirmed that medicare doesn't pay for benzos. I told her that was strange since so many senior citizens are prescribed ativan.

    I will continue to check this out.
  4. butterflydream

    butterflydream New Member

    Are you speaking of medicare Part D (prescription drug plan).

    I had thought medicare Part B (medical plan) is not for prescriptions????
  5. zeowa

    zeowa New Member

    Sorry if this is off-topic, and I am sorry that I don't yet know about what Medicare will cover, but I wonder if someone would be kind enough to direct me to info about generic vs. brand name for CFIDS. Although I've heard about this concerning Neurontin/gabapentin, I have not heard this about this Benzo.

    Thanks in advance for any help!
  6. greatgran

    greatgran Member

    Medicare part A nor B will NOT pay for any medicines just for medical only. Medicare part D is for your medicines, I have Medicare part D and take xanax and it WILL NOT pay for any Benzos. Medicare part D is extra that you have to suscripe for and pay out of pocked. I also have the Medicare Supplement and it will not pay for medicines, it just picks up the 20% medicare doesn't pay.. Haven't found anything that will pay for Benzos..except the insurance I had when I was able to work.

    I did call the company I have my Medicare Part D with and ask why they would not pay for Benzo's.. Well like most doctors and those who don't understand our conditions.."Its a medicine not needed". They will pay for antidepressants. So no way I could appeal.. Now are you speaking of just Medicare or do you also receive Medicaid, Medicaid is all different.

    Medicare will not pay for a lot of test we may need. Needless to say I am disappointed in Medicare but its better than nothing.

    Not sure how much longer I will be able to afford part D and the supplement.

    God Bless,

  7. justlooking

    justlooking New Member

    Yes it is true Medicare D doesn't cover any benzodiazepines. So Xanex, Klonopin, Valium, Ativan are not covered. They are all different types of Benzodiazepines, but classification Benzodiazepine (clonazepam, lorazepam, alprazolam, diazepam, temazepam, triazolam, oxazepam there are a few others but I can't remember them all now) none are covered by Medicare part D.
    I think it is so funny that Viagra is covered but not anti-Anxiety drugs... Unbelievable. We know who thinks what is more important. Sexual satisfaction for Men over leading a normal life for people with anxiety or some with depression or other mental health issues!
    A perfect reason to keep Government out of making medical choices for American Citizens. Sorry not trying to be political.
  8. Mikie

    Mikie Moderator

    Medicare Part D does not cover any drugs in the benzo family. Even if one has a "replacement" Medicare Advantage plan, which includes Part D, the plan will usually not cover any drug which Medicare will not cover. Medicare figures that these meds carry risks and that there are other meds which will more safely address the symptoms addressed by the benzos; i.e., if one takes Klonopin, one could switch to Neurontin. For me, Klonopin is a better choice and I use the generic and pay for it myself. I'm lucky because the generic seems to work as well for me as the brand name.

    Some on Medicare, who have plans from employers, have Rx coverage which covers meds not covered by Medicare. In those cases, the commercial plan is usually primary with Medicare as the secondary, just the opposite of what most of us carry.

    I have a Medicare Advantage HMO/PPO plan which includes Part D. I pay no premium and only pay when I use it through co-pays or co-insurance. For me, it's a good deal and so far, has paid well when I needed it. These plans are not available everywhere.

    Love, Mikie
  9. romalaw

    romalaw Member

    for all your replies. I meant to type medicare part D, but sometimes my brain and hand don't communicate. So I guess the information I was given is correct. I intend to appeal so I'll let all of you know how I fare.

    I too am disgusted that medicare would cover viagara and not a class of drugs so commonly prescribed. Must be men making the decisions. As a woman over 60, I can tell you that having a "working" partner is not high on my priority list.