Medicare does not cover Monistat 7 as a prescription medication

Monistat 7 is an over-the-counter antifungal cream used to treat yeast infections. Because it is sold without a prescription at drugstores and online, Medicare Part B does not cover it. Medicare covers prescription drugs through Part D (if you have that coverage) and some medications through Part B, but over-the-counter products fall outside both categories.

The cost of Monistat 7 varies by location and retailer, but typically ranges from $8 to $15 per box. You pay the full price yourself at the register. Some pharmacies offer discounts if you use a coupon or a discount card like GoodRx, which can lower the cost further. The generic version, miconazole nitrate, is often cheaper than the brand name and works the same way.

Key Takeaways

  • Monistat 7 is an over-the-counter medication, so Medicare Part A, Part B, and Part D do not cover it under any circumstances.
  • You pay the full retail price out of pocket, which typically ranges from $8 to $15 per box depending on where you shop.
  • Discount cards like GoodRx, SingleCare, and RxSaver are free tools that show you the lowest price at pharmacies near you.
  • If your doctor prescribes a different antifungal medication such as fluconazole, that prescription drug may be covered under Part D if you have that coverage.
  • Prescription antifungals sometimes cost less with a Part D copay than Monistat 7 costs out of pocket, so it is worth asking your doctor about options.

When a prescription antifungal might be covered instead

If you have a yeast infection that does not improve with over-the-counter treatment, or if your doctor recommends a prescription antifungal, ask about fluconazole or other prescription options. These are covered under Medicare Part D if you have that coverage, though you will pay a copay or coinsurance based on your plan. Fluconazole is often a single-dose pill, which makes it simpler than a multi-day cream.

Your Part D coverage depends on your specific plan. Some plans cover antifungal medications with a low copay; others place them in a higher cost tier. Check your plan's formulary (the list of covered drugs) on Medicare.gov or call your plan to find out what you would pay. Many people find that the Part D copay is lower than the retail price of Monistat 7, especially if they have a low-cost tier for common medications.

How to find the lowest price for Monistat 7

Since Medicare does not cover Monistat 7, your best option is to compare prices across pharmacies. Chain drugstores like CVS, Walgreens, and Walmart often have different prices for the same product. Some pharmacies offer a lower price if you ask about a generic version, which works the same way as the brand name and is usually $2 to $5 cheaper.

Discount cards and coupons can also help. GoodRx, SingleCare, and RxSaver are free apps and websites where you enter the medication and your zip code to see prices at nearby pharmacies. Manufacturer coupons are sometimes available on the Monistat website or through your pharmacy. Always compare the coupon price with the discount card price — one is often better than the other. Some people save $3 to $5 by using a discount card instead of paying the regular pharmacy price.

What Medicare Part D covers for fungal infections

Part D covers prescription antifungal medications, but not over-the-counter ones. Common prescription antifungals include fluconazole (a single-dose pill), terbinafine, and miconazole prescription cream. These are usually less expensive with Part D coverage than buying Monistat 7 out of pocket, especially if your copay is low or if your plan places antifungals in a preferred tier.

If you do not have Part D coverage, you can still buy prescription antifungals without it — you just pay the full pharmacy price. In some cases, the pharmacy price for a prescription antifungal is lower than the retail price of Monistat 7, so it is worth asking your doctor and checking prices before you decide. Your pharmacist can tell you the cash price of a prescription antifungal if you ask.

Talking to your doctor about treatment options

If you have tried Monistat 7 and it did not work, or if you have frequent yeast infections, tell your doctor. They can prescribe a medication that may work better for your situation and that Part D will cover. Your doctor can also rule out other conditions that might look like a yeast infection but need different treatment.

When you see your doctor, mention that you are on Medicare and ask whether they recommend a prescription antifungal. If they do, ask them to check your Part D formulary before writing the prescription so you know what your copay will be. Some doctors' offices can do this check in the same visit, and it takes only a few minutes. This step saves you from finding out the cost after you fill the prescription.

Frequently Asked Questions

Can I use a coupon or discount card to pay less for Monistat 7?

Yes. GoodRx, SingleCare, and RxSaver are free and show you the lowest price at pharmacies near you. Manufacturer coupons are sometimes available on the Monistat website. Compare both options because one is often cheaper than the other at your local pharmacy.

If my doctor prescribes fluconazole instead, will Medicare Part D cover it?

Most Part D plans cover fluconazole, though you will pay a copay or coinsurance. Check your plan's formulary on Medicare.gov or call your plan to see what your cost would be. In many cases, the Part D copay is lower than the full retail price of Monistat 7.

Why does Medicare not cover over-the-counter medications?

Medicare Part A and Part B cover hospital and doctor services. Part D covers prescription drugs. Over-the-counter medications are not covered by any Medicare part because they do not require a doctor's prescription and are available to anyone at a drugstore.

What if I have a Medigap or Medicare Advantage plan instead of Original Medicare?

Medigap plans do not cover over-the-counter medications either. Medicare Advantage plans sometimes include Part D coverage, but Monistat 7 still would not be covered because it is over-the-counter. Check your plan documents or call your plan to confirm what antifungal medications are covered.

Is the generic version of Monistat 7 as good as the brand name?

Yes. The generic version is miconazole nitrate, and it contains the same active ingredient in the same strength. It works the same way and costs less. Both are over-the-counter, so neither is covered by Medicare.