Does Medicare Cover Phenadoz?

Phenadoz is often prescribed to treat allergies or nausea. It’s a relatively inexpensive medication covered by 51% of Medicare prescription drug plans. There are available generic versions that may help you save money if you need to take this medication. 

Basic Information About Phenadoz

The active ingredient in Phenadoz is promethazine. This is an antihistamine and antiemetic. The drug is commonly used to treat motion sickness, nausea,  vomiting and allergic reactions. You may also be prescribed Phenadoz after surgery, as it can help combat pain and nausea. 

Phenadoz provides promethazine in the form of rectal suppositories. Oral drugs used to treat vomiting can be less effective if you're unable to keep the medication down. A rectal suppository continues to be effective, even if you vomit after using it. 

How Do I Find Out if My Medicare Covers Phenadoz?

Every Medicare insurance plan has a formulary. A formulary provides the generic and brand-name prescription drugs that are covered by the health plan. Your insurer should have this list on the website. Otherwise, you can call your insurer and request a copy of the formulary, which can then be sent electronically or in the mail. You should look at the formulary for your plan, as insurers may use different formularies for different plans.

Some medications require prior authorization before being covered by an insurance plan. In these cases, your doctor must contact the insurer to confirm the medication is medically necessary. Once this is done, the insurance company will cover the medication.

How Much Does Phenadoz Cost With Medicare?

Your out-of-pocket costs for Phenadoz depend on your plan and whether you’re still paying the deductible or paying the co-pay. Your deductible is the amount you pay before Medicare begins covering costs. It can be as low as $0, but in 2024 this amount cannot exceed $545. If you haven’t met your deductible, you may need to pay for the full cost of the drug. 

Once you’ve met your deductible, you'll only pay the co-pay for the medication. This is either a flat fee or a percentage of the cost of covered medications. You may find that generic versions of the drug, or the use of discount vouchers, are more affordable than using your insurance plan.