Does Medicare Cover AUVI-Q? 

Some allergic reactions can be life-threatening, but there are tools available to help you deal with an incident. AUVI-Q is a brand-name epinephrine injection that physicians can prescribe to treat sudden and severe allergic reactions including anaphylaxis. 

AUVI-Q can be self-administered into your thigh (or you can have someone else administer it for you) by using a pre-filled, single-dose autoinjector. Even if you feel better after administering the shot of epinephrine, you should seek immediate medical attention to ensure that you don’t have an allergic relapse. 

If you haven’t heard of AUVI-Q, you may have heard of EpiPen. Both prescription drugs are similar because they contain the active drug epinephrine (or adrenaline), and they’re both self-injectable treatments for emergency allergic reactions. However, AUVI-Q injections come in three strengths, and they all have a “talking” feature that guides you through the steps of injection. 

Your physician could suggest that you try AUVI-Q if you’re prone to allergies or at risk for anaphylaxis, so you might be wondering if your Medicare insurance covers a portion of the expense. 

Does Medicare cover prescriptions of AUVI-Q? 

To get coverage for any type of epinephrine auto-injector such as AUVI-Q, EpiPen, or generic epinephrine, you must be enrolled in a Medicare prescription drug plan. 

If you’re enrolled in Original Medicare Part A (hospital insurance) and B (medical insurance), you can purchase a stand-alone Medicare Part D (prescription drug) plan from a private insurance provider that works with Medicare. If you prefer Medicare Advantage (Part C), you can enroll in a plan that offers prescription drug coverage as part of your plan (or an MA-PD). 

Every Medicare prescription drug plan has its own list of covered drugs known as its formulary, and it must include a wide range of prescription drugs commonly taken by Medicare beneficiaries. However, every Part D plan has the option to include or exclude a host of other drugs that aren’t as commonly prescribed. 

As of now, most Medicare prescription drug plans don’t cover the AUVI-Qbrand of epinephrine injector. 

On the other hand, some plans do cover the EpiPen brand, and most Part D plans cover the generic form of the epinephrine injector. 

Whether you have coverage depends on your Medicare prescription drug plan, so you should look at your plan’s formulary to find out what type of epinephrine injector it covers. 

The amount of money you pay for a prescription of epinephrine depends on which drug tier your Part D plan categorizes it. Most generic drugs are either tier-one or tier-two with a $0 or low copayment. If your plan carries the EpiPen brand, it is probably on a higher tier because it’s a brand-name drug, and the higher tiers generally carry higher copayment amounts. 

How much does AUVI-Q cost without Medicare insurance coverage? 

As with all prescription drugs, prices vary depending on where you live and where you shop. The national average cost of AUVI-Q without insurance is approximately $735 per package of two auto-injectors. 

The manufacturer of AUVI-Q (Kaleo) might be offering a manufacturer’s discount for those who qualify, so it might be worthwhile looking into this. Also, some retail pharmacies found across the United States offer coupons or discounts when you purchase some types of prescription drugs like AUVI-Q from them. 




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