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Entresto & Medicare

discussing prescription coverage with a doctorEntresto is one of the life-saver types of medication for patients suffering from cardio-vascular diseases.

These drugs ensure patients of lowering the risks of cardiovascular death and hospitalization for heart failures with its combination of sacubitril and valsartan.

Because the costs of this medication are very high, patients in need might be asking whether Entresto is covered by Medicare.

Medicare & Prescription Drugs

Prescription drug coverage is provided by Medicare to all its clients, on the condition that they have joined a plan run by Medicare Prescription Plan D. This segment of the insurance allows patients in need of drug coverage to obtain their medication easily and efficiently. It helps you pay for both brand name and generic drugs and there are two ways of obtaining these facilities:

  • PDPs – Medicare Prescription Drug Plans add prescription drug coverage to Original Medicare
  • PPOs or HMOs – Medicare Advantage Plans that also offer prescription drug coverage for patients in need

Those who choose to apply for one of these insurance plans should read very carefully the list of prescription drugs covered by Medicare, as they may vary from plan to plan.

Apart from that, all Medicare Plan D patients will be provided with all drugs in the following category: antidepressants, antipsychotics, anticonvulsants, antiretrovirals, immunosuppressants and anticancer. All the drugs in the other categories are either more difficult to obtain or the time of wait might be longer.

In order to obtain Entresto, you should check your insurance plan first, as the plan possessed should best accommodate the personal prescription drug needed. 

Nevertheless, Entresto is covered by Medicare in some cases. Be sure to check your plan and discuss with your doctor the terms and conditions required for you to be able to take this type of medication. Medicare covers the costs of Entresto and displays the following types of this medication:

  • ENTRESTO 24 MG-26 MG TABLET (Sacubitril and Valsartan)
  • ENTRESTO 49 MG-51 MG TABLET (Sacubitril and Valsartan)
  • ENTRESTO 97 MG-103 MG TABLET (Sacubitril and Valsartan)

These are available only under the circumstances mentioned above. You need to have a PDPs or a PPOs/ HMOs insurance in order to be able to get this medication. Be sure you keep in touch with your insurance plan before sending requests regarding the prescription medication you need and also update the plan every time a new prescription is added to your health plan.

When working with a BGA Insurance agent, we determine what is covered for FREE! This is to ensure that your current plan is in fact the best plan for you. If you think you may be spending too much or aren’t sure whether you can get the drugs you need, contact us right away!

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