Does Medicare Cover Armour Thyroid?

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Armour Thyroid is a medication used to treat thyroid disorders caused by insufficient hormone production from the thyroid gland. These disorders range from mild to severe and include conditions like hypothyroidism, Grave’s disease, and even thyroid cancer.

It contains desiccated natural thyroid hormone derived from the thyroid glands of pigs. Armour Thyroid is known for its unique formulation that includes both T3 (triiodothyronine) and T4 (thyroxine) hormones, making it a popular choice for some patients.

Signs of low thyroid hormone levels can vary and may include:

  • Memory problems or brain fog
  • Feelings of sadness or depression
  • Swelling and bloating, especially in the face
  • Joint pain
  • High cholesterol levels
  • Difficulty losing weight and weight gain
  • Feeling excessively cold
  • Hoarseness in voice
  • Dry skin
  • Constipation
  • Hair loss or thinning
  • General tiredness or fatigue
  • Slower heart rate
  • Neck lumps or swelling
  • Difficulty swallowing
  • Shortness of breath

If you are experiencing any of these symptoms, please seek the guidance of your Primary Care Physician (PCP) or a healthcare professional. Armour Thyroid comes in tablet form and contains thyroid hormones. Its main purpose is to restore normal hormone levels in the body. Your doctor will determine the right dosage for you based on tests and monitoring.

Armour Thyroid is not covered by most Medicare or private insurance plans, though coupons and manufacturer discounts can help pay towards the cost of Armour Thyroid. Medications such as levothyroxine replace the thyroxine hormone, and is covered by many Medicare and insurance plans.

Medicare Coverage for Armour Thyroid

Armour Thyroid is an oral medication approved by the FDA, often prescribed by doctors to treat low thyroid hormone levels. It’s commonly used for conditions like hypothyroidism, Hashimoto’s disease, thyroid nodules, goiter, or thyroid cancer. If you have Medicare Part D coverage, it might help with the cost of Armour Thyroid. However, if it’s not covered, the out-of-pocket expense can vary based on your location and pharmacy pricing. On average, 100 tablets of 15mg Armour Thyroid cost around $80 in the United States. If you have an optional Medicare Part D plan or a Medicare Advantage plan with prescription drug benefits, Armour Thyroid may be included in your plan’s formulary.

When it comes to determining whether Medicare covers Armour Thyroid, it is crucial to consider the specific Medicare plans and their coverage provisions. Let’s explore the two main components of Medicare and their potential coverage for this medication:

Original Medicare (Part A and Part B)

Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). Unfortunately, Original Medicare does not typically cover prescription medications that you take at home, including Armour Thyroid, unless they are administered during a covered inpatient or outpatient procedure.

However, there might be some exceptions. In certain cases, if you receive Armour Thyroid as part of a medically necessary procedure or during a hospital stay, Part A or Part B may cover the medication. It is important to consult with your healthcare provider and carefully review the specific circumstances to determine if you qualify for coverage.

Medicare Part D Prescription Drug Plans

Medicare Part D Prescription Drug Plans provide coverage for prescription medications, including Armour Thyroid, when taken at home. These plans are offered by private insurance companies approved by Medicare. To access coverage for Armour Thyroid, you need to enroll in a standalone Medicare Part D Prescription Drug Plan or a Medicare Advantage plan that includes prescription drug coverage.

When selecting a Part D plan, it is essential to review the plan’s formulary, which is a list of covered medications. Each plan has its own formulary, which may include Armour Thyroid or an alternative medication with a similar therapeutic effect. It is advisable to check the formulary details, including any restrictions or limitations, and ensure that Armour Thyroid is covered before enrolling in a specific plan.

Alternatives for Obtaining Coverage

If Medicare does not cover Armour Thyroid or you are looking for potential alternatives, here are a few options to consider:

  1. Medicare Advantage Prescription Drug (MAPD) Plans: Medicare Advantage plans, also known as Part C plans, are offered by private insurance companies approved by Medicare. These plans combine the benefits of Original Medicare (Part A and Part B) with additional coverage, including prescription drugs. Some Medicare Advantage plans may cover Armour Thyroid, so it is worthwhile to explore the available options in your area.
  2. Medicaid: If you meet the eligibility criteria for Medicaid, a joint federal and state program that provides healthcare coverage for low-income individuals, you may be able to obtain coverage for Armour Thyroid. Medicaid programs vary by state, so it is important to check with your local Medicaid office to determine if you qualify and to understand the specific coverage provisions in your state.
  3. Patient Assistance Programs: Pharmaceutical companies often offer patient assistance programs that provide medications at reduced or no cost to individuals who meet specific criteria. These programs can be a valuable resource for those who require Armour Thyroid but face financial constraints. It is advisable to contact the manufacturer of Armour Thyroid or consult with your healthcare provider to explore available patient assistance programs.

Key Points:

  • Original Medicare (Part A and Part B) does not typically cover Armour Thyroid when taken at home.
  • Medicare Part D Prescription Drug Plans offer coverage for Armour Thyroid.
  • Review the formulary of each plan to ensure Armour Thyroid or a suitable alternative is covered.
  • Consider alternatives such as Medicare Advantage plans, Medicaid, or patient assistance programs if Medicare coverage is not available.

Helpful Resources:

  1. Medicare.gov – Medicare Part D Prescription Drug Coverage
  2. Medicaid.gov – Medicaid Eligibility
  3. AbbVie Patient Assistance Foundation (Manufacturer of Armour Thyroid)

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