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does Medicare cover Lovenox injections

Does Medicare Cover Lovenox Injections?

Lovenox is an anticoagulant medication used to prevent the blood from clotting. The purpose of Lovenox is to prevent medical conditions such as deep vein thrombosis and pulmonary embolism.

So a common question many people have is, “does Medicare cover Lovenox injections?” In this article, we answer that question in clear, plain English. You will also find the average costs of Lovenox and other helpful info.

Does Medicare Cover Lovenox Injections?

The short answer is no. In most cases, Medicare will not cover the cost of Lovenox injections. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Lovenox. 

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for Lovenox. Parts A and B do not provide coverage for Lovenox. This is because they mainly cover medically necessary services, equipment, and treatment rather than prescription drugs.

Part C and Part D Coverage for Lovenox

However, Medicare Advantage plans (Medicare Part C) may provide coverage for Lovenox injections. Medicare Advantage plans cover everything Original Medicare covers as well as some additional benefits. However, coverage and out-of-pocket costs will vary depending on the specifics of your plan.

Medicare Part D plans also provide coverage for Lovenox. 100 percent of both Medicare Part C and Part D plans provide coverage for the medication Lovenox. 

Most Medicare plans restrict the amount of purchase for Lovenox per one time. If you need to purchase a greater amount of Lovenox at one time, Medicare may not cover it. You can either wait until the period has passed before refilling or contact your plan provider and ask for an exception.

The Medicare drug formulary lists Lovenox as a Tier 4 drug. Most of the time Tier 4 medications are non-preferred brand medications. Tier 4 medications are more expensive than Tier 1, 2, and 3 medications. 

How Much Does Lovenox Cost?

A set of 12 syringes of 40 mg of Lovenox can cost from around $300 up to $1,000. This cost will vary depending on the pharmacy where you will buy it. Coupons are commonly available so you often don’t have to pay the full retail price.

What Is The Difference Between Lovenox and Eliquis?

Though they are both used for preventing blood clots, they have a couple of differences. The first notable difference between the two medications is their generic variant. Lovenox’s generic variant is called Enoxaparin while Eliquis’ generic variant is Apixaban. 

Another difference is some of their side effects. For example, Eliquis may cause skin rashes as a side effect while Lovenox may cause reactions such as swelling in the injection site.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare Cover Robotic Surgery?

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