Ritalin (Methylphenidate) Medicare Coverage

Ritalin is a schedule II controlled medication used to treat attention deficit/hyperactivity disorder (ADD or ADHD) and symptoms of narcolepsy. The generic form of Ritalin is called Methylphenidate.

Ritalin Immediate Release (IR) is typically taken twice daily, while Ritalin Sustained Release (SR) is typically taken once daily.

Ritalin is a stimulant of the brain and increases levels of norepinephrine and dopamine. Common side effects of Ritalin include dizziness, sleepiness, dry mouth, headache, upset stomach, loss of appetite, insomnia and nose and throat irritation.

How much does Methylphenidate cost with Medicare?

Methylphenidate 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 Methylphenidate?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Methylphenidate, the generic form of Ritalin in 2023.¹

• Medicare Advantage plans or Part D plans that cover Methylphenidate 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 Methylphenidate. 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

Ritalin should be taken 30-45 minutes before eating a meal. If you take Ritalin more than 1 time daily, take your second dose before 6pm to avoid insomnia.

Long acting (sustained release) Ritalin should be taken in the morning. Talk to your pharmacist about how to take the medication properly.

Ritalin is a schedule II controlled substance due to its high potential for abuse, misuse and addiction.

Ritalin can sometimes cause heart problems. Talk to your doctor if you experience an abnormal heartbeat, weakness on one side of the body, trouble speaking or thinking, chest pain or pressure, shortness of breath, dizziness or fainting.

Changes in mood and behavior have occurred while taking Ritalin. If you have a change in thinking, increased anger, hallucinations, depression or mood swings, talk to your doctor immediately.

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.