Quetiapine (Seroquel) Medicare Coverage

Quetiapine is a medication typically used to treat bipolar disorder, major depressive disorder and schizophrenia. The brand name equivalent of Quetiapine is called Seroquel.

Quetiapine is typically taken one to two times daily, depending on what type of Quetiapine you take. Quetiapine comes as an immediate release or extended release drug.

Quetiapine works in the brain to increase dopamine and serotonin levels. Major side effects include dizziness, headache, feeling nervous or excited, constipation, fatigue, hunger, weight gain, upset stomach, back pain and stuffy nose.

How much does Quetiapine cost with Medicare?

Quetiapine 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 Quetiapine?

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

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

The immediate release tablets can be taken with or without food. If you are taking the extended release tablet, take it on an empty stomach or with a light amount of food.

It is important to take Quetiapine according to your doctor’s instructions. Stopping Quetiapine abruptly can result in withdrawal symptoms and extreme side effects.

In some children and young adults who take it, Quetiapine can increase the risk of suicidal thoughts or actions. This risk is higher in people who have had these thoughts or actions prior to starting Quetiapine. Call the doctor if you experience any suicidal thoughts or changes in mood.

There can be an increased risk of death in elderly people who take Quetiapine for mental problems due to dementia. This drug is not approved to treat mental problems caused by dementia.

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.