Does Medicare cover tavaborole?
Tavaborole (brand name Kerydin) is a prescription medicine used to treat toenail fungal infections (onychomycosis). Medicare coverage is not determined by the name alone—it depends on whether tavaborole is covered under your specific Medicare plan and what form it is prescribed in (Part D vs Part B).
Most oral and topical prescription drugs for outpatient use are covered under Medicare Part D (or a Medicare Advantage plan that includes Part D). Whether tavaborole is covered depends on each plan’s drug formulary and tier placement.
Will it be covered under Medicare Part D or Medicare Advantage?
If you have prescription coverage through:
- Medicare Part D, tavaborole is typically considered a Part D drug.
- Medicare Advantage (MA) with prescription coverage, tavaborole is also typically handled under the plan’s Part D formulary rules.
To confirm coverage, you generally need to check:
- The plan’s formulary (drug list)
- Your drug’s cost-sharing tier
- Any prior authorization or step therapy requirements
What if tavaborole isn’t on your plan’s formulary?
If tavaborole is excluded or placed on a high-cost tier, the plan may require one of these before covering it:
- Prior authorization (your prescriber must document medical necessity)
- Step therapy (you must try other antifungal treatments first)
- Coverage with restrictions (dose, duration, or diagnosis limits)
If it’s not covered, you can ask your plan for an exception or a formulary alternative.
How much will it cost if Medicare covers it?
Costs vary widely by plan because Medicare Part D uses plan-specific premiums, deductibles, and copays/coinsurance. Even when a drug is covered, your out-of-pocket cost depends on:
- Your plan’s tier for tavaborole
- Whether you’ve met your deductible (and where you are in the benefit phases)
- Any prior authorization approved
- Whether generic alternatives apply (coverage rules still vary by plan)
Fastest way to check your exact coverage
Look up “tavaborole” (Kerydin) in your plan’s drug formulary or use the plan’s member portal. If you tell me your plan type (Original Medicare with Part D, or Medicare Advantage) and the plan name (or a screenshot of the formulary result), I can help you interpret what the plan is likely to require (tier, authorization, and expected next steps).
Sources
No sources were provided with the question, so I can’t cite coverage details for tavaborole specifically from Medicare.gov or a formulary database here.