Does Medicare Cover Zyvox?

Medicare Benefits Solutions
Feb 8, 2021

Zyvox is a powerful antibiotic that your doctor may prescribe to help fight certain types of bacterial infections. It works to slow down or stop bacterial growth. It won’t cure your infection if it’s from a virus, but it may help treat specific complex skin infections or types of pneumonia caused by strains of streptococcus pneumonia and staphylococcus aureus. 

What is Zyvox?

Zyvox falls into the drug category of oxazolidinone. It was originally an MAO inhibitor, and it was used to treat Parkinson’s disease, depression, and other medical conditions. These medications alter your brain’s chemistry. MAO is an enzyme that degrades any neurotransmitters you have that are involved in lifting your mood. They include dopamine, serotonin, and norepinephrine. MAOIs act like an antidepressant. If you’re a Medicare recipient, you’ll want to know whether or not your Medicare benefits extend to this medication. 

How Zyvox is administered

The liquid form of this medication is usually administered by a medical professional using an IV. It can take between half an hour to two hours from start to finish. You get it twice a day for 10 to 28 days. In special circumstances, your doctor may allow your caregiver or patient to administer the medication at home through an IV using very specific instructions. 

If you get the oral form of Zyvox, you’ll usually take it twice a day, once every 12 hours. For children taking this medication, you could have a shorter time span based on their weight and age. Stopping the medication too soon or stopping it altogether increases your risk of infection. 

Zyvox Side Effects

Side effects of this medication can result from interactions with some foods like cured meats, sauerkraut, aged cheese, fermented soy products, or draft beer. You should work with a dietitian when you take this medication to get advice on how to alter your diet while you take it. 

You also want to be very aware of any potential drug interactions it could have with your other prescriptions. Make sure that you talk to your doctor about all of your current medications and discuss how they interact with Zyvox. This can help you avoid having any adverse interactions when you add it to your regimen. It can also reduce the potential that this antibiotic can interfere with any benefits your other medications give you. 

Medicare Benefits and Zyvox Coverage

For Medicare recipients, Part B can help cover the cost of the medication if they get it in IV form in an outpatient setting. If you get the oral medication to take by yourself at home, Medicare Part D will help cover the costs. 

Medicare Part D is optional drug coverage you can add to Medicare Part A and Part B. It’s important to have it because Part A and Part B don’t cover the costs of prescription medication. Only Part D provides coverage for prescriptions. You can enroll in a stand-alone Prescription Drug Plan if you have Original Medicare, or you can enroll in a Medicare Advantage plan that includes prescription drug coverage. It’s important to note that Part D isn’t mandatory coverage. However, you may want to enroll when you’re first eligible to avoid a late enrollment penalty later. 

Many Part D plans will cover this medication. You may have to pay a deductible, coinsurance, or copay before you get it. The average price for this medication when you get it through an IV is $4,630. This can really add up quickly. For oral medications, it can cost around $50 for a treatment’s worth of 20-milligram tablets. 

Costs and coverage of Zyvox may vary between Prescription Drug Plans and MA plans with prescription drug coverage. If you’re not sure whether your Medicare benefits extend to this medication, contact your plan directly.