Does medicare cover butalbital acetaminophen caffeine codeine?

Medicare may cover butalbital/acetaminophen/caffeine/codeine—but it depends on how it’s prescribed and which Medicare plan you have, because Medicare coverage is generally based on whether the drug is a covered formulary medication and whether you’re receiving it under Part B vs Part D.

Key points

• This combination is typically a prescription medicine, so coverage usually falls under Medicare Part D (prescription drug coverage), not Part B.
• The exact coverage depends on your plan’s drug formulary and rules such as:
  • Prior authorization (plan may require extra approval)
  • Step therapy (trying other meds first)
  • Quantity limits
  • Copay tier (cost varies by tier)
• Some opioid-containing products (it contains codeine) can have additional plan restrictions.

What to check (fast)

1. Look up the drug on your plan’s Part D formulary (or call the number on your Medicare card).
2. Confirm the exact product/strength (brand/generic and mg amounts matter).
3. Ask whether it requires prior authorization or has quantity limits.

If you tell me 2 things, I can guide you more specifically

1. Are you on Original Medicare + Part D or a Medicare Advantage (Part C) plan?
2. Do you know the name/strength on the bottle (exact mg or brand)?