Gemfibrozil (Lopid) Medicare Coverage

Gemfibrozil is a medication used to treat high lipids and high triglycerides, commonly referred to as high cholesterol. It works by stopping your liver from releasing bad cholesterol while it increases good cholesterol.

Gemfibrozil is typically taken twice daily. The brand name version of Gemfibrozil is called Lopid.

Gemfibrozil is typically well tolerated, but it can cause stomach pain, heartburn and diarrhea.

How much does Gemfibrozil cost with Medicare?

Gemfibrozil 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 Gemfibrozil?

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

• Medicare Advantage plans or Part D plans that cover Gemfibrozil 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 Gemfibrozil. 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

Controlling your cholesterol is very important to reduce the risk of heart attack and stroke.

Gemfibrozil works to lower cholesterol, but you may not feel the effects. Do not stop taking Gemfibrozil without talking to your doctor.

Take the first dose of Gemfibrozil 30 minutes before breakfast and the second dose 30 minutes before dinner. Avoid taking colestipol or cholestyramine within 2 hours of taking gemfibrozil.

If you experience muscle pain, talk to your doctor. Gemfibrozil can cause muscle aches and weakness that can indicate a muscle problem that may or may not impact the kidneys.

Gemfibrozil can cause gallstones. Signs of gallstones include sudden pain in the upper right stomach or between the shoulder blades, yellow skin or eyes or fever with chills.

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.