Acetaminophen-Codeine (Tylenol/Codeine) Medicare Coverage

Acetaminophen-codeine is a combination of two different medications to treat mild to moderate pain. The brand name equivalent is Tylenol with codeine.

Acetaminophen-codeine is a schedule 3 controlled substance due to its potential for abuse and addiction.

Acetaminophen-codeine is typically given for a short period of time for acute pain management. The major side effects of Acetaminophen-codeine include dizziness, constipation, stomach pain, upset stomach, vomiting, sweating and headache.

How much does Acetaminophen-Codeine cost with Medicare?

Acetaminophen-Codeine coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Acetaminophen-Codeine?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Acetaminophen-Codeine in 2023.¹

• Medicare Advantage plans or Part D plans that cover Acetaminophen-Codeine include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Acetaminophen-Codeine. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Additional information

You can take this medication with or without food, but you can take it with food if acetaminophen with codeine upsets your stomach.

Acetaminophen-codeine is an addictive pain medication that can lead to abuse and misuse. This can lead to overdose or death. Only use acetaminophen with codeine as prescribed by your doctor.

This medication can also cause breathing problems. Call your doctor if you experience slow or shallow breathing.

Codeine is an opioid pain medication. When used with other drugs like benzodiazepines or alcohol, this medication can make you extremely drowsy. Side effects include slowed breathing and even death.

Benzodiazepine drugs are drugs like alprazolam, diazepam and lorazepam.

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Written by Hayden Gharibyar, Pharm.D.