Does Medicare cover Zoloft? 

Zoloft is a medication that doctors prescribe to treat specific conditions like major depressive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder and obsessive-compulsive disorder.

Clinical depression in older adults is not uncommon. According to WebMD, “late-life depression affects about 6 million Americans ages 65 and older.”

Depression in older adults

Symptoms of depression that older adults present are sometimes misinterpreted as side effects of medications or associated with chronic conditions. Examples include fatigue, sleeplessness, irritability, confusion, low attentiveness, weight or appetite changes, and suicidal thoughts. 

Medicare Part B covers annual depression screening as a preventive service. To qualify for this benefit, your doctor must perform the screening in the doctor’s office or another primary care facility where you can get follow-up treatments and referrals. To ensure you get this benefit at no cost, check if your healthcare provider accepts assignment, which means the provider agrees to the fee Medicare stipulates for this service.

Early evaluation followed by treatment is critical because depression in older adults can interfere with rehabilitation from illness and may contribute to heart disease. If you are diagnosed with depression, your doctor may prescribe counseling, various types of therapy, medication or a combination of treatments. 

Does Medicare prescription drug coverage (Part D) cover Zoloft?

Medicare Part D is insurance for prescription drugs, an optional plan you can purchase for a monthly premium in addition to your Part B premium. The best time to enroll in Part D is during your Initial Enrollment Period when you are newly eligible. Delaying enrollment may result in a late penalty, unless you have non-Medicare insurance comparable to Part D (creditable prescription drug coverage). The late fee could increase your premium for as long as you have Part D coverage.

Medicare prescription drug coverage plans include a formulary, a list of covered drugs, categorized by tiers. The lower tiers contain generic drugs and are the least expensive. The higher levels include brand and specialty medication associated with higher prices. Your share of the cost varies with the plan you purchase. When searching your plan’s formulary for Zoloft, also look for the generic version, sertraline.

You can switch to another Medicare prescription plan during the annual Open Enrollment Period, October 15 through December 7. If you are a member of a Medicare Advantage plan with prescription drug coverage, you have an opportunity to switch during the annual Medicare Advantage Open Enrollment Period, January 1 through March 31. 

Getting help for depression

You can reach the Suicide & Crisis Lifeline at 988lifeline.org and by calling or texting 988. This resource is a new offering in the 2023 Medicare handbook.