Ativan is a well-known brand name for lorazepam. Medicare Part D prescription drug coverage for this medication may require proof of medical necessity.
Conditions Treated by Ativan
As a benzodiazepine, lorazepam, sold under the brand name Ativan, can help you manage anxiety. Doctors may also prescribe Ativan to help treat symptoms of alcohol withdrawal, bipolar disorder, gastrointestinal distress due to chemotherapy or insomnia.
If your physician prescribes Ativan to take at home, it will typically be the oral tablet form. Lorazepam is sold as an injection, but its use in this form is more common in a hospital or inpatient setting. Your prescription may begin with a low dose and gradually increase over time. Stopping this medication may be done by gradual decreases, as well.
Benefits and Risks Associated with Ativan
The medication can produce a calming, sedating effect by enhancing a natural amino acid in the body known as GABA (gamma-Aminobutyric acid). Although the medication is not classified as a narcotic, patients report effects that are similar to narcotics. This can include drowsiness or impaired vision, as well as feeling faint or experiencing dizziness.
Prior medical history plays an important role in your doctor’s ability to prescribe Ativan safely. Preexisting conditions, current prescription medications, over-the-counter drugs and supplements can all pose a risk of interaction. Known allergies should be included in your medical record to further minimize risk.
Medications like Ativan may require careful administration, which means you may need to withdraw from them carefully if you plan to stop taking the medication. A physician will need to monitor your progress as there can be withdrawal symptoms associated with this class of drug. Side effects maybe more apparent for older patients.
This medication is classified as a controlled substance and can pose a risk of addiction, particularly for those who have a personal or family history of substance abuse.
Medicare Coverage for Ativan
Because Ativan is classified as a controlled substance, Medicare coverage may be limited or may require prior authorization and documented proof of medical necessity. Although Original Medicare does not provide coverage for most medications prescribed for use at home, Part A or Part B benefits may cover its use in a clinical setting.
In most cases, Part D prescription drug coverage is only applicable if a medication is prescribed for its FDA-approved use. When prescribed for off-label use, instead, you may be required to pay the full cost of your prescription out of pocket. If your prescribing physician shows that off-label use is medically necessary and no Medicare-covered alternative is available, you may be able to appeal a denial of coverage.
Prescription drug plan formularies are not standardized, which means the list of drugs covered by a plan changes from one insurer to the next. Coverage can also differ between plans offered by the same insurance carrier, so it’s important to check each formulary for the medications you want covered.