Medicare Part D and many Medicare Advantage plans cover EpiPens. However, they may cover only the generic form of EpiPen, epinephrine. Your costs will depend on your Part D or Medicare Advantage plan.

An EpiPen is a portable epinephrine injection prescribed for emergency treatment of severe allergic reactions.

Medicare offers coverage for EpiPen prescriptions mostly through Part D (prescription drug) plans or Medicare Advantage plans that include prescription drug coverage. In some cases, Original Medicare may also cover it. The cost of an EpiPen will depend on your specific plan.

However, there might be some limits. Your plan might only cover generic epinephrine and not the name-brand EpiPen. It could also limit the number of times it’ll cover a prescription in a year or other set period of time.

Read on to learn more about which parts of Medicare cover EpiPens.

When to seek emergency care: Symptoms of anaphylaxis

Seek emergency care right away if you or someone else are experiencing:

  • shortness of breath
  • swelling in your throat
  • dizziness

Your EpiPen coverage with Medicare will depend on which part of Medicare you’re using.

Part A (hospital insurance)

Medicare Part A covers hospital stays and other inpatient care. It generally doesn’t pay for medications. However, if you’re given an EpiPen injection while receiving inpatient care, Medicare Part A will cover it.

Part B (medical insurance)

Medicare Part B covers you for services like:

It generally doesn’t cover any prescriptions you take at home. But if you receive an EpiPen injection while you’re receiving care — for example, at an urgent care center — Part B will cover it.

Part C (Medicare Advantage)

Medicare Part C is also called Medicare Advantage. Advantage plans must cover everything that Parts A and B do. Together, Parts A and B are known as Original Medicare.

Many plans also include coverage for prescriptions, so these would cover EpiPen.

Part D (prescription drug coverage)

Medicare Part D offers prescription drug coverage for Medicare beneficiaries. Most Part D plans will cover EpiPen in some form.

The cost to you will depend on your plan.

Medicare supplement (Medigap)

Medicare supplement plans, known as Medigap, cover some of the out-of-pocket costs of Medicare. They don’t offer any additional coverage for prescriptions and won’t affect your coverage for EpiPen.

EpiPens can be very expensive prescriptions. According to the latest drug spending data from the Centers for Medicare & Medicaid Services (CMS), Medicare Part B spent almost $12,000 on epinephrine in 2022. In the same year, Part D plans spent between $39,000 and more than $100 million, depending on the type and brand.

In terms of your out-of-pocket cost, copayments range between $0 and $127 for a 2-pack of the generic form (epinephrine) and nearly $700 for the brand name (EpiPen).

The good news is that Medicare can help you cover the cost. Your price will depend on your plan, your pharmacy, and the drug you want.

In most cases, you would get your coverage under Part D, so your first step should be to check your Medicare Part D or Medicare Advantage plan’s formulary. A formulary is a list of prescriptions that your plan covers.

You’ll need to enter information like your ZIP code, any prescriptions you have, and your pharmacy. You’ll then see plans in your area that include your prescriptions in their formulary and any copayments you’ll be responsible for.

The formulary will let you know what’s covered and your cost. You can then check local stores and see what coupons or savings are available. After using coupons, you can compare the price on your plan’s formulary with the price, then choose the more affordable option.

That said, while these prices might seem high, remember that you don’t need to use an EpiPen every day—you might never need to use your prescription. So, though EpiPens are expensive, even in their generic form, they are not a cost you’ll need to budget for every month like you would any other prescriptions.

How to use and store EpiPens
  • Keep your EpiPen in its container with the lid on.
  • Have two EpiPens in a place you can easily get to.
  • Store your EpiPens in cool, dark places at temperatures between 59°F and 86°F.
  • You should never refrigerate your EpiPen.
  • You can keep your EpiPen in a purse or wallet, but it’s important to make sure it doesn’t get too warm or too cold.
  • Be careful keeping your EpiPen in your car’s glove compartment on very hot or very cold days.
  • It can be a good idea to get a case just for your EpiPens that you can easily transfer from your bag to your desk to your car.
  • Check the expiration date on your EpiPen. Your pharmacy can help you safely dispose of an expired EpiPen.
  • You can buy practice EpiPen injectors at a low cost. You can use them to get a feel for how to use the EpiPen so you’re prepared for an emergency.

Does private insurance cover EpiPens?

Whether or not a private insurance plan covers EpiPens and your out-of-pocket cost depends on the plan.

How to get EpiPen for free?

You can ask by speaking with your allergist. Sometimes, doctors will have free samples that they can give out. In addition, look up state and federal assistance programs and manufacturer coupons. Just be mindful of the rules around such coupons. For example, while the manufacturer of EpiPen offers a savings program, Medicare recipients are not eligible.

EpiPens are prescribed for use during severe emergency allergic reactions. An EpiPen can be a lifesaving measure that allows you to reach the emergency room and get full care.

EpiPens are expensive, with costs for the brand name reaching as high as $700 for a two-pack.

Medicare can help you cover the cost. Most Part D and Medicare Advantage plans include EpiPens or the generic epinephrine in their formulary. Your costs will depend on your plan but could be as low as $0.