Metformin (Glucophage) Medicare Coverage

Metformin is a medication that is used to help control blood sugar levels in patients with type 2 diabetes. The brand name equivalent of Metformin is Glucophage.

Metformin is typically taken twice a day. It helps decrease sugar production by your liver and helps insulin work better in your body.

The most common side effects of Metformin include upset stomach, gas, diarrhea, fatigue and headache.

How much does Metformin cost with Medicare?

Metformin 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 Metformin?

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

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

Metformin is best taken with meals and with a full glass of water.

Metformin drug may be used alone or in combination with other diabetes medication. Even if your blood sugars are controlled and you begin to feel better, do not stop taking Metformin without talking to your doctor. This medication is very important in helping you prevent complications due to diabetes.

Metformin should be used along with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes.

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.