Adderall: Is Medicare Covered?


Adderall
Latin American patients talking to the hospital manager and a doctor about their health insurance coverage
  • Medicare and Adderall
  • Which parts can be covered?
  • What are prescription drugs?
  • How much will it cost?
  • What is Adderall?
  • bottom line
  • Medicare can help you pay for your Adderall prescription drug.
  • You can get coverage with a Medicare Part D or Medicare Advantage (Part C) plan.
  • Most plans only cover the generic version of Adderall, the amphetamine salt combination.
  • Your cost will depend on your specific Medicare Part D or Medicare Part C plan.

Adderall is a commonly prescribed medication used to treat attention deficit hyperactivity disorder (ADHD). While many people associate ADHD and Adderall with children and young adults, in reality, Adderall is also prescribed for older adults.

In fact, the advocacy group Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) reports that as many as 10 million adults have ADHD. Many of these adults are Medicare beneficiaries.

Medicare offers coverage for Adderall in most Medicare Part D or Medicare Advantage (Part C) plans. Your cost for Adderall with Medicare will depend on your specific plan. However, in many cases, you can use Medicare to buy a generic form of Adderall (amphetamine salt combination) for a lower price.

  • Adderall is a controlled substance.
  • Adderall can form a habit.
  • Never mix Adderall with alcohol. Mixing Adderall with alcohol can cause alcoholism, heart disease, impaired judgment, and more.
  • If you take Adderall too late in the day, it may make it difficult for you to sleep.

Does Medicare cover Adderall?

You can get coverage for Adderall prescriptions through Medicare. Your coverage depends on your specific plan, but most Medicare Part D and Medicare Advantage plans cover Adderall.

Depending on your plan, you may only cover the generic version of the amphetamine salt combination.

What parts of Adderall are covered by Medicare?

Your coverage for Adderall depends on which part of Medicare you use.

original medical insurance

Parts A and B are collectively referred to as “Original Medicare” and do not cover prescription drugs. Medicare Part A is hospital insurance and Medicare Part B is health insurance. You can use this coverage for hospital admissions, emergency room visits, doctor visits, and medical equipment.

However, you cannot use Original Medicare to cover any drug, including Adderall.

Original Medicare pays Adderall only if you receive care in a hospital or skilled nursing facility.

Medicare Part A will cover Adderall during your stay at these facilities; however, after discharge, Medicare Part A will no longer cover this cost.

This means that if you want Medicare to pay for your Adderall prescription, you need to go beyond your original Medicare.

Medicare Part C

Medicare Part C is also known as Medicare Advantage. These plans are offered by private companies and regulated by Medicare.

Plans must offer the same coverage as Original Medicare, but most plans offer additional coverage including prescription options.

Medicare Part D

Medicare Part D is standalone prescription coverage. In addition to your original Medicare or Medicare Advantage plan, you can use a Part D plan to cover any prescription drugs you take.

Both Advantage plans and Part D plans need to be purchased separately. The exact plans available to you depend on where you live, as many plans are only available in certain states or territories.

Your plan will include costs associated with it, such as monthly premiums, deductibles, and copays. You can use the Medicare website’s plan finder tool to compare Advantage and Part D plans in your area.

Medicare Supplemental Plan (Medigap)

Medicare supplemental plans, also known as Medigap plans, are designed to help you cover the out-of-pocket costs of Original Medicare. When you have a Medigap plan, you get coverage for the following expenses:

  • deductible
  • coinsurance payment
  • co-payment

However, Medigap plans do not offer other prescription drug coverage. You still need a Part D or Advantage plan to get coverage from Adderall.


Casey Harward

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