{"id":630444,"date":"2024-11-14T10:13:35","date_gmt":"2024-11-14T15:13:35","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630444"},"modified":"2026-01-07T13:26:18","modified_gmt":"2026-01-07T18:26:18","slug":"does-medicaid-cover-nurtec","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicaid-cover-nurtec\/","title":{"rendered":"Does Medicaid cover Nurtec?"},"content":{"rendered":"

Migraines<\/span><\/a> can be challenging for those who suffer from them. If you experience acute or episodic migraines, you understand how crucial it is to find an effective treatment. Nurtec ODT<\/a> (rimegepant) is a brand-name prescription medication that\u2019s taken as an orally disintegrating tablet (ODT). It works by blocking <\/span>calcitonin gene-related peptide (CGRP)<\/span><\/a>, a protein responsible for migraine pain. You can take Nurtec ODT as needed for immediate relief of acute migraine or every other day as a preventive treatment for chronic migraine. Nurtec ODT can be expensive, especially without insurance. Understanding Medicaid coverage can make a huge difference in managing migraines.<\/span><\/p>\n

Does Medicaid cover Nurtec ODT?<\/span><\/h2>\n

Medicaid coverage for medications can vary significantly based on the state in which you reside. Each state has its own Medicaid guidelines for drug coverage. For example, <\/span>Texas Medicaid<\/span><\/a> covers Nurtec as a preferred drug, but it requires prior authorization and proof that other treatments have not been effective. <\/span>Michigan Medicaid<\/span><\/a> covers Nurtec as a preferred drug, but it requires prior authorization and has age requirements and quantity limits.\u00a0\u00a0<\/span><\/p>\n

To determine if your state covers Nurtec ODT, check your state’s Medicaid website or call your local Medicaid office. They can tell you if Nurtec ODT is covered and what you need to do to get it.<\/span><\/p>\n

Factors influencing Medicaid coverage for Nurtec ODT<\/span><\/h3>\n

If your state’s Medicaid program does cover Nurtec ODT, there may be specific criteria you need to meet. For example, many Medicaid programs require prior authorization before covering certain medications. This special approval process requires your healthcare provider to submit a request to Medicaid explaining why Nurtec ODT is needed for your treatment. They may also require <\/span>step therapy<\/span><\/a>, which involves trying a less expensive migraine treatment before covering Nurtec ODT.\u00a0<\/span><\/p>\n

How much does Nurtec ODT cost?<\/span><\/h2>\n

The average retail price of Nurtec is $1,382 for a box of 8 orally disintegrating tablets. The price fluctuates, though, and it varies greatly by dosage, pharmacy, and location, among other factors. If you have insurance, Medicare, or Medicaid, you\u2019ll likely pay much less.<\/span><\/p>\n

Cost of Nurtec ODT with Medicaid<\/span><\/h3>\n

The cost of Nurtec with Medicaid will depend on your specific plan and state guidelines. Medicaid generally helps reduce medication costs, but you might still have some expenses:<\/span><\/p>\n