Sumatriptan (Imitrex) Medicare Coverage

Sumatriptan is a medication used to treat cluster headaches and moderate to severe migraines, with or without aura. The brand name equivalent of Sumatriptan is called Imitrex.

Sumatriptan works by reducing inflammation of the nerves and constricting your blood vessels to relieve headache and migraine. It is typically taken once at the onset of the headache or migraine.

Common side effects of Sumatriptan include dizziness, fatigue, feeling warm, upset stomach and vomiting. Side effects of the nasal spray version include changes in taste, burning and nose or throat irritation.

How much does Sumatriptan cost with Medicare?

Sumatriptan 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 Sumatriptan?

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

• Medicare Advantage plans or Part D plans that cover Sumatriptan 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 Sumatriptan. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or 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

Sumatriptan should only be taken at the onset of a headache or migraine. It is not a medication that is taken every day.

If your headache comes back or does not resolve after the first dose, you can use another dose if your doctor allows it. Make sure you know how far apart to space each dose.

If you are using the Sumatriptan injection, it can be given under the skin as early as possible after the headache or migraine has started. Wash your hands before and after giving the injection, and always use a clean needle.

Use the Sumatriptan nasal spray in the nose only, not by mouth. Blow your nose before use and sit down while taking it.

Since Sumatriptan is only taken at headache onset, major side effects are rare. However, these can include eye problems, heart problems, worsening headache, seizures, high blood pressure, burning and numbness.

Talk to your doctor right away if you experience any side effects that seem abnormal.

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.