Does Insurance Cover Accutane?

Does Insurance Cover Accutane

This popular medication has changed the lives of many who suffer from cases of severe acne and other skin problems. Making millions of people resort to it. But, the real question is this: does insurance cover Accutane?

Fortunately, insurance usually covers Accutane in the states. Although you should contact your insurance provider to check beforehand. 

What is Accutane Exactly?

The American Food and Drug Administration (FDA) granted Accutane its initial acne therapy approval in 1982. The producers stopped producing the brand-name medication Accutane in 2009.

It is now known by its generic name: isotretinoin.

However, the majority of people still call the medication by its brand name today. A vitamin A derivative that is administered at a very high dose is called accutane.

The substance is similar to medications like Retin-A and it is a member of the retinoids pharmacological class.

Accutane has been examined extensively and has been prescribed more than two million times . This is due to the significant risk of adverse effects connected with the drug.

What Does Accutane Treat?

Accutane is used when alternative forms of therapy have failed to control moderate to severe forms of acne.

The medication is most often used to treat cystic or nodular acne. Although it can also be used to treat other forms of acne that have not responded to therapy.

Large, uncomfortable outbreaks that develop deep beneath the skin are the hallmark of cystic acne. Similar to how bacteria trapped in blocked pores creates typical pimples. Which frequently are the main cause of this condition.

An infection spreads deep into the skin when you have cystic acne. Resulting in a pus filled cyst. This type of acne is more prevalent in men and can develop on the face, chest, back, shoulders, or upper arms.

Sometimes, the condition can be serious enough to leave behind permanent scars. Resulting in damaged skin and low self-esteem.

Getting Accutane with Insurance

In general, any health insurance in the United States will cover Accutane. However, businesses only permit its usage when cystic acne is the diagnosis or when other treatments have failed to treat the acne.

The patient must have tried other treatments such as antibiotic gel, orates antibiotics, benzoyl peroxide, and Retin A with unsuccessful results before insurance will grant reimbursement for this prescription.

Your plan will determine how much various insurances will cost you. It might be better to contact the insurance provider for further information on this.

The average cost of this prescription with insurance is between $100 and $150. A big discount from the real retail cost at specialized pharmacies.

Getting Accutane without Insurance

In the past, buying Accutane out of pocket would have been too expensive for the majority of patients. Today though, it’s frequently more economical.

There are several generic variants of Accutane available right now, and some pharmacies charge extremely affordable pricing.

For a normal dose of 30 milligrams administered twice a day, patients will spend, on average, between $300 and $400 if they want to cover the cost of their own care.

Most patients who need this medication need to take Accutane for six months.

Many acne patients would rather pay out-of-pocket for Accutane than put off starting treatment while they wait for a prolonged prior authorization process to be completed.

Utilizing a pharmacy discount card or looking for a pharmacy with the lowest costs might assist to reduce the cost of treatment and avoid a lengthy delay in starting Accutane therapy due to financial issues.

Does Insurance Cover Accutane (1)

You must enroll in the FDA’s iPLEDGE program while using Accutane, which mandates that women of reproductive age consent to use two types of birth control while taking the medication.

The iPLEDGE program’s objective is to stop pregnant women from using Accutane, which can lead to serious birth abnormalities.

Your doctor will need to request blood tests to determine your cholesterol and triglyceride levels and to ensure that your kidney and liver functions are normal before you begin your treatment plan.

Since urine-based pregnancy test results might be incorrect, it is also required for female patients to confirm and document the findings of two negative pregnancies using blood tests before writing your prescription.

After that, in order for your refill to be approved, you will need to see your doctor every month so they can input the findings of a negative pregnancy test into the iPLEDGE database.

You’ll also be undergoing monthly lab testing. The reason? To ensure that the levels you’ve already had checked remain stable.

Regular medical visits and lab testings will have expenses associated with them. These expenses could be partially or entirely covered by your insurance plan, but at the very least, you should prepare to pay a copay.


Accutane is covered by insurance most of the time. Which will considerably cut down the costs that come with taking it. It depends on what insurance provider you are with.

They may cover the full price or some of the price and you must prove that you have tried other medications beforehand as Accutane is powerful and is seen as a last resort.  

You should be aware of other fees though. Such as routine blood tests and examinations that are done in order to track your body’s reaction to the Accutane.

Some providers will also cover these fees, but you should prepare to pay a copay. 

Frequently Asked Questions

Why is Accutane so expensive?

Because it is the sole medication of its type, Accutane is pricey.Even though other pharmaceutical companies produce Accutane under various trade names, it is still the only prescription medication that has the strength and effectiveness to treat severe acne.

Are there any side effects with Accutane?

A rash, chapped lips, dry skin, and muscular aches are a few minor Accutane side effects that might occur. Serious birth abnormalities are Accutane’s most harmful adverse effect if used while pregnant. It is crucial that women avoid getting pregnant while using Accutane or taking it while already pregnant

It’s crucial to avoid sharing Accutane since the birth abnormalities it might cause are so severe.

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