Mycophenolate (Cellcept) Medicare Coverage

Mycophenolate is a medication used to prevent rejection of an organ transplant in patients who receive a kidney transplant, heart transplant or liver transplant. Mycophenolate intentionally weakens the immune system to prevent it from attacking the transplanted organs.

The brand name equivalent of Mycophenolate is called Cellcept. It is typically taken twice daily.

Common side effects of Mycophenolate include back pain, constipation, headache, dizziness, loss of appetite, diarreha, gas, fatigue, upset stomach, insomnia and joint pain.

How much does Mycophenolate cost with Medicare Advantage?

Mycophenolate coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Mycophenolate?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Mycophenolate in 2023.¹

• Medicare Advantage plans or Part D plans that cover Mycophenolate include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Mycophenolate. We represent carriers such as Humana, Aetna, UHC, Anthem BCBS, Wellcare, Cigna Healthcare, and Kaiser Permanente.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Additional information

Take Mycophenolate on an empty stomach at least 1 hour before or 2 hours after meals unless your doctor has told you otherwise. Talk to your doctor before getting any vaccines, as some vaccines can raise the chance of infection while taking Mycophenolate.

If you are able to become pregnant, trusted birth control to prevent pregnancy is important while taking Mycophenolate. Mycophenolate can cause birth defects and death of an unborn baby.

Mycophenolate can increase your risk for cancers like lymphoma or skin cancer and can also increase your risk for bad infections. Signs of cancer include change in color or size of a mole, skin lump or growth, noticeable weight loss, night sweats or swollen glands.

Signs of infection include fever, chills, flu-like symptoms, sore throat, ear and sinus pain, cough or a wound that won’t heal. To reduce your risk of infection, wash your hands often and avoid people who are sick.

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Written by Hayden Gharibyar, Pharm.D.