Lyrica is a medication used to treat nerve pain, seizures, and other conditions. Medicare parts C and D may cover Lyrica, but its generic version may cost less.

Pregabalin (Lyrica) is a very popular medication used to treat conditions like fibromyalgia, nerve pain, seizure disorders, and others.

Medicare Part D and Medicare Advantage (Part C) plans may or may not cover Lyrica specifically, but they will cover pregabalin, the generic version. Each Medicare prescription plan sets its own costs for brand-name medications and their generic versions.

Even if the Lyrica brand name drug is covered under your plan, it will probably be more expensive than the generic version.

Keep reading to learn what conditions Lyrica treats, how Medicare covers this medication, and how much you can expect to pay.

Pregabalin is covered by Medicare Part D and Medicare Advantage (Part C) plans. Some plans may also cover the brand Lyrica, but you may have to pay the difference in cost between the generic and brand-name prices. This is because the brand cost is typically higher, and plans tend to cover generics when they are available.

If you’re eligible for Original Medicare (Part A and Part B), you can choose to enroll in Part D and Part C plans.

These plans are offered by private insurance companies that contract with Medicare. You can choose from various plan options based on your budget, location, and coverage needs.

Part C plans often include prescription drug coverage along with many other healthcare benefits, while Part D plans only offer prescription drug benefits.

Every plan has different deductibles, coinsurance, and copay costs. Both types of plans may have restrictions on using specific doctors and pharmacies within their network for maximum cost savings.

You can contact your plan provider directly to ask how much Lyrica might cost you. You can also use Medicare’s plan finder tool to compare different Medicare plans, costs, and coverage based on where you live.

Enter “Lyrica” under your prescriptions to see the average cost where you live.

The cost of Lyrica depends on what type of Medicare plan you have (Part D or Part C) and your individual plan’s coverage rules. All Part D plans have formularies, or lists of covered medications, based on Medicare guidelines.

Plan formularies have several tiers based on the cost of the medications (generic, brand, or specialty). Generic pregabalin is usually on tier 1 or the lowest cost for most plans. You may have to pay a higher cost if you want Lyrica.

Some plans only cover generic pregabalin. Check with your plan for specific coverage questions and costs.

Medicare plans may also have a limit on the number of days’ supply you can get for Lyrica. This might also cost you more in deductibles and copays since you tend to pay less when you fill a large supply of medication at one time.

You may be able to save money on the cost of Lyrica, or the generic, if you qualify for certain Medicare savings programs, Medicaid, or other medication assistance or rebate programs. However, since brand name Lyrica is more expensive, it likely wouldn’t be covered by any income-based savings programs because a generic is available.

Here are a few options to look into if you find you need help paying for your medications.

Extra Help

The Medicare low income subsidy, or Extra Help program, helps pay for prescription medication premiums and copays. You must meet certain income and financial need thresholds to qualify for this program.

SHIP

State Health Insurance Assistance Programs (SHIP) can help answer questions about Medicare plans. They can also help you find financial assistance for prescription medications or other healthcare costs in your local area.

Medicaid

After Medicare pays its share, the Medicaid program may pay all or most of the cost for certain medications. Check with your state Medicaid office to see if you qualify.

Medicare savings programs

There are four Medicare savings programs that are run by state Medicaid offices. These programs help pay for certain Medicare costs, such as premiums, deductibles, coinsurance, and copays. They also cover prescription medications if you meet certain income and other financial qualifications.

PACE

The Program of All-Inclusive Care for the Elderly (PACE) can also help with Part D-covered prescription medications, like pregabalin, if you qualify. You don’t need to have a separate Part D plan if you qualify for the PACE program.

Pricing sites and rebates

Search pharmacy discount sites like Optum Perks to compare Lyrica’s pricing and costs. These sites will show prices for brand name and generic forms of Lyrica from different pharmacies.

If you want the brand name Lyrica, contact the manufacturer, Viatris, and ask about any rebates or discount programs. If you qualify, the Lyrica Co-Pay Savings Card can save on the cost of your prescription. Ask your doctor or healthcare professional about this savings card program.

Lyrica is a prescription medication for treating several types of nerve pain, including:

It may also be prescribed for partial-onset seizures.

Pregabalin, the generic version of Lyrica, was approved in 2019 and has made the medication much more affordable, even without prescription drug coverage.

Although the exact way Lyrica works isn’t definitively known, scientists believe it calms overactive or damaged nerves that can lead to seizures or pain.

Lyrica is a Schedule V controlled substance due to its potential for misuse. However, it isn’t an opioid medication.

Potential side effects and other considerations

Two of Lyrica’s most commonly reported side effects are dizziness and sleepiness. Until you know how this medication will affect you, be careful driving, operating machinery, or doing any tasks that require alertness.

Lyrica may cause suicidal thoughts or behavior. Call 911 or your local emergency number if you experience changes in your mood, worsening depression, or thoughts of harming yourself.

You can also call or text a crisis hotline, such as the 988 Suicide and Crisis Lifeline at 988.

Other side effects of Lyrica may include:

  • blurry vision
  • dry mouth
  • weight gain
  • difficulty concentrating
  • swelling of hands and feet

Let your doctor know if you have a history of heart-related problems, trouble breathing, allergic reactions to medications, substance misuse, depression, or mood-related issues. Taking Lyrica might affect these conditions. Your doctor will discuss the risks versus the benefits of Lyrica with you before prescribing the medication.

It’s also recommended to avoid alcohol or opioid medications while taking Lyrica. These can have additive side effects like drowsiness, sleepiness, and dizziness, which could be dangerous.

Your doctor may prescribe a lower dose of Lyrica if you have a kidney condition because the medication may build up in your body and potentially cause more harm to your kidneys.

Although Lyrica isn’t an opioid medication, suddenly stopping the medication can cause withdrawal symptoms in some people.

Symptoms of withdrawal include:

  • Medicare Part D and Medicare Advantage (Part C) plans cover Lyrica and generic pregabalin, but coverage and costs will vary.
  • Depending on your Medicare plan, you may have to pay more if you want the Lyrica brand name medication. Check with your individual plan to learn more about Lyrica’s cost.
  • Your doctor will discuss the benefits and risks of Lyrica and if the medication could help manage your symptoms.
  • You can also check out these resources to help manage fibromyalgia, diabetic neuropathy, and chronic pain.