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Medicare & Narcan: A Guide to Finding a Life-Saving Medication

Narcan's usefulness in combatting the opioid epidemic has helped garner over-the-counter approval. Narcan (generic name: naloxone) is now available over-the-counter and covered under most Medicare Advantage plans. Narcan's alternatives may still require prescriptions, but most Medicare Part D plans cover those prescription options. Stakeholders nationwide are looking for answers to help solve the opioid crisis, and Narcan and its equivalents are a vital piece of the puzzle in solving this issue.

Key takeaways:

What is Narcan? Is Narcan the same as Naloxone?

Narcan is a popular brand-name version of an anti-opioid medication known as naloxone. Scientifically, Narcan is an “opioid antagonist,” meaning the medication rapidly reverses opioid-induced overdoses. Just like Ford or Chevy are brands of cars, Narcan is just one of several brands of naloxone, so Narcan is naloxone. Opioid overdoses can be triggered by the overuse of “street” drugs and/or FDA-approved medications containing opiates.

Examples of medications or substances that contain opiates are morphine, fentanyl, codeine, oxycodone (OxyContin®), hydrocodone (Vicodin®), all of which carry a risk of addiction and/or overdose. Remember, when used appropriately and in moderation, medications are essential innovations of modern medicine that can help people lead happy and healthy lives. However, overuse carries the risk of adverse health effects such as overdoses. In 12 months ending in October 2022, there were over 100,000 fatal overdoses in the United States. Narcan is an important tool to curb the devastating effects of widespread opioid overdoses in the United States.

The nasal spray version of naloxone is an FDA-approved prefilled, needleless device that does not require assembly and is sprayed into one nostril while the person experiencing the overdose lays on their back. In March, the FDA approved an over-the-counter version of Narcan nasal spray. This device is designed to be easy to use by loved ones and bystanders. This past month (August 2023), the FDA approved a second over-the-counter medication, RiVive™ nasal spray, from Harm Reduction Therapeutics, a nonprofit pharmaceutical group. Harm Reduction Therapeutics’ product is expected to hit the market in early 2024.

Naloxone brands

With Narcan gaining approval for over-the-counter sale and use at a suggested retail price of $44.99, it’s important to know if your Medicare plan covers over-the-counter medications or if your Medicare Part D plan covers another brand of naloxone that requires a prescription. When considering different brands of naloxone, it’s important to note that naloxone comes in many brand names and a few other forms; popular American brands include:

Brand nameUsageDosage size
NarcanNasal spray4 mg
EvzioInjectable2 mg/0.4 ml
KloxxadoNasal spray8 mg
RiViveNasal spray3 mg
ZimhiInjectable5 mg /0.5 ml

Does Medicare cover Narcan?

Most Medicare Part D plans cover prescription Narcan, which will be available over-the-counter starting September 2023. The out-of-pocket cost to purchase Narcan or other alternatives will vary based on the brand of medication and the type of Medicare plan and coverage. Since Narcan specifically will be available over the counter, the Medicare Advantage plan is the only potential coverage option, depending on the plan type and the state where you live. Medicare Advantage plans, also known as Medicare Part C, may offer allowances that cover over-the-counter medications.

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Is Narcan available over the counter?

In fact, 87% of Medicare Advantage plans offer some over-the-counter benefits. If you are Medicare eligible, consider purchasing a Medicare Advantage plan in your purchase of over-the-counter medications such as Narcan. Other brands of naloxone will still require a prescription, and Medicare Part D covers prescription medications. Licensed Medicare sales representatives will provide the relevant information you need to make an informed decision.

How does Narcan work?

Narcan how it works

Think of the brain or the body as a toddler’s shape-shorter toy. When an overdose occurs, opiates flood the brain’s/body’s receptors with “blocks” to fill those holes. Narcan blocks those holes in the receptors and prevents the intake of more opiates; it also can kick those opiate blocks out of the holes and fill and replace them until the overdose episode subsides. According to the Medicare website, Narcan is available today as a nasal spray but can also be administered via a traditional syringe injection, atomizer, or an auto-injector. Though helpful, accessible, and practical, a person who uses Narcan should still seek emergency medical treatment after administering the overdose reversal medication.

I have Medicare Part D, how much will I have to pay for naloxone?

If you have not yet reached your deductible, you’ll likely pay $35–54. After you’ve met your deductible, prescription naloxone ranges from $0–54. These numbers vary by plan and state. Since Narcan is now available over the counter, Medicare won’t cover your purchase unless you have a Medicare Advantage plan that covers over-the-counter medication. It’s essential to consult a licensed Medicare sales agent when considering which plan is right for you.

Where can I buy Narcan, or other brands of naloxone?

Over-the-counter Narcan will be available at pharmacies such as Walgreens and CVS. Other brands of naloxone will be available with prescriptions from a doctor. The over-the-counter version of Narcan comes in the version of a 4 mg nasal spray and contains two doses. Kloxxado is also a nasal spray and is similar to Narcan. Though it requires a prescription, Kloxxado will be covered under Medicare Part D if you do not have a Medicare Advantage Plan (Part C). Another brand of naloxone, Evizio, is also available via prescription and covered under Medicare Part D. Evzio is an auto-injection medication injected into a vein, under the skin, or muscle. A health worker, emergency medical provider, or a trainer family member/caregiver can administer Evzio. When the second over-the-counter medication, RiVive, hits the market, access to life-saving naloxone will continue to expand.

Overdoses are scary, but you are not alone. There are tools to help you protect yourself and your loved ones.


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