How Much Is Anxiety Medication With And Without Insurance

Recent data reveal that nearly half of adults–43%, to be exact–feel more anxious than they did just a year ago. Despite this, a 2023 study found that more than 11% of US adults with anxiety aren’t getting the treatment they need.

Why is this happening? Experts point to cost as one of the biggest barriers. Depending on the type of medication, whether it’s generic or a brand name, and insurance coverage, prices can range anywhere from $4 to $3,895.

In this article, we’ll explore the cost of anxiety medications, comparing options for those with and without insurance to find accessible, affordable care.

Types of Anxiety Medications

Anxiety medications come in different types to target specific symptoms and patient needs. Here’s a breakdown of the main types:

1. Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are commonly prescribed as a first-line treatment for depression and other psychiatric disorders. They hold FDA approval for treating several anxiety disorders, including:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder
• Panic disorder

SSRIs work by increasing serotonin levels in the brain, a neurotransmitter that impacts mood. They do this by blocking the reabsorption, or reuptake, of serotonin in nerve cells. This action keeps more serotonin available in the brain, which can improve mood and enhance emotional response.

The SSRIs commonly prescribed in the US include:

• Fluoxetine (Prozac, Symbyax)
• Sertraline (Zoloft)
• Paroxetine (Paxil, Paxil CR, Pexeva)
• Fluvoxamine
• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Vilazodone (Viibryd) - Off-label use only, which means that practitioners may prescribe this drug for anxiety, even though it lacks FDA approval for that specific condition

2. Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work similarly to SSRIs, targeting serotonin reuptake. However, they also inhibit the reuptake of norepinephrine, another neurotransmitter involved in mood regulation. SNRIs are recognized as a primary treatment option for GAD.

Available SNRIs in the US that are prescribed for anxiety include:

• Duloxetine (Cymbalta)
• Venlafaxine (Effexor, Effexor XR)
• Levomilnacipran (Fetzima) - Off-label use only
• Desvenlafaxine (Pristiq) - Off-label use only

3. Benzodiazepines

Benzodiazepines are effective for providing quick, typically within 30 minutes to an hour, short-term relief from anxiety symptoms. They help alleviate muscular tension, promote relaxation, and reduce the intense symptoms associated with anxiety.

Common benzodiazepines prescribed for anxiety are:

• Alprazolam (Xanax, Xanax XR)
• Clobazam (Onfi) - Off-label use only
• Clonazepam (Klonopin)
• Clorazepate (Tranxene)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Oxazepam (currently lacks a brand-name version)

4. Buspirone

Buspirone belongs to a class of drugs called azapirones. It primarily targets serotonin receptors in the brain, though it doesn’t fully activate them. Unlike benzodiazepines, buspirone has minimal risk of causing sedation or dependency. However, it has a slower onset of action, typically requiring 2 to 4 weeks for full clinical effect.

Buspirone is mainly prescribed for treating GAD. It’s often considered a second-line treatment option when patients either don’t respond to SSRIs or experience intolerable side effects. In the US, buspirone is only available in its generic form.

5. Beta Blockers

Beta-blockers are primarily used to manage the physical symptoms of anxiety by slowing the heart rate and reducing adrenaline's impact on the body. Currently, there are no beta-blockers that are FDA-approved specifically for anxiety. Both propranolol and atenolol are indicated for conditions like high blood pressure and heart-related issues but are commonly prescribed off-label for anxiety.

6. Tricyclic Antidepressants (TCAs)

TCAs and SNRIs share a similar mechanism in that both block the reabsorption of serotonin and norepinephrine in the brain. TCAs prescribed for anxiety are only used off-label. Examples are:

• Amitriptyline
• Nortriptyline (Pamelor)
• Imipramine
• Clomipramine (Anafranil)

How Much Is Anxiety Medication With Insurance

Your costs vary greatly depending on your coverage details, like copays and deductibles. To give you an idea, let’s look at the US Department of Veterans Affairs (VA) 2024 copay structure as an example:

Note: The tier your medication falls under significantly influences your out-of-pocket cost. Additionally, the copay amounts increase with longer supply durations.

For example, the generic medication sertraline is classified as a Tier 1 medication, resulting in a $5 copay for a 30-day supply. This $5 is the amount you pay at the time of service, and the VA covers the remaining cost of the medication. In contrast, brand-name medications like Lexapro or Xanax fall under Tier 3, with a copay of $11 for a 30-day supply.

Private insurance providers also use tiered copay structures:

Another example, Cymbalta, is covered by 62% of insurance plans with copays between $60 and $87.50. Keep in mind that your copay amounts also vary depending on your individual circumstances, such as your priority group assignment or any specific health conditions you have. Factors like deductibles, coinsurance, and out-of-pocket maximums also impact total expenses.

Other variables can also influence how insurers decide which medications to cover and under what conditions. For instance, in UnitedHealthcare’s 2024 list, branded drugs like Cymbalta, Celexa, and Prozac may be excluded from coverage or require prior authorization for certain plans in Connecticut, New Jersey, and New York.

To get the most accurate information, consult your plan’s formulary, which details covered medications, tiers, and restrictions.

Does Insurance Cover Off-Label Use?

Insurance coverage for off-label anxiety medication is often more variable. Health plans typically assess these requests based on several factors, including:

• Whether the medication has FDA approval
• If the condition being treated is serious or rare
• Whether conventional treatments have proven ineffective
• If the medication is included in an approved compendium (a resource compiled by experts that evaluates and rates medications for both approved and off-label uses)

Does Medicare Cover Anxiety Medication?

Medicare Part D provides coverage for nearly all medications within the six protected drug classes, which includes antidepressants (SSRIs, SNRIs, and TCAs). However, the following drugs are not classified as antidepressants:

• Benzodiazepines
• Buspirone
• Beta Blockers

While benzodiazepines fall outside the antidepressant category, Medicare Part D has included coverage for these medications since 2013.

Does Medicaid Cover Anxiety Medication?

Medicaid coverage varies by state. For instance, in North Carolina, Zoloft is classified as a non-preferred drug, while its generic version, sertraline, is preferred. To receive coverage for brand-name Zoloft, you may need to try two other preferred SSRIs first and demonstrate that they were ineffective.

How Much Is Anxiety Medication Without Insurance

Without insurance, the cost of anxiety medication can be prohibitive. Here’s an approximate:

Category: SSRIs and SNRIs
Generic: A 30-day supply costs $4-$135. Citalopram is the least expensive, and venlafaxine ER is the most costly. Sertraline and escitalopram, the two most prescribed antidepressants dispensed in the US in 2022, are priced at $8.95 and $5.97, respectively.

Branded: Celexa (citalopram) and Prozac (fluoxetine) are among the priciest, costing $730.73 and $620.37. The least expensive branded option is Cymbalta (duloxetine), at approximately $296.

Category: Benzodiazepines
Generic: A 30-tablet supply of the lowest doses of generic versions ranges from $17.42 to $74.89, with diazepam being the least expensive and clorazepate the most expensive.

Branded: Prices start at $102.66 and can reach up to $1,214, with Ativan (lorazepam) as the most expensive and Klonopin (clonazepam) as the least expensive.

Category: Benzodiazepines
Generic: A 30-tablet supply of the lowest doses of generic versions ranges from $17.42 to $74.89, with diazepam being the least expensive and clorazepate the most expensive.

Branded: Prices start at $102.66 and can reach up to $1,214, with Ativan (lorazepam) as the most expensive and Klonopin (clonazepam) as the least expensive.

Category: Buspirone
Generic: Has an average retail price of $13.02 for 30 tablets at the lowest dose.

Branded: only available in its generic form

Category: TCAs
Generic: Prices range from $10.58 to $203.63 for 30 tablets or capsules, with imipramine being the least expensive and clomipramine the most costly.

Branded: Pamelor (nortriptyline) and Anafranil (clomipramine) are significantly more expensive, averaging $1,251 and $3,895, respectively.

Category: Beta Blockers
Generic: A 30-count of generic propranolol at the lowest dose averages

Branded: only available in its generic form

Additional Treatment Costs for Anxiety

There are several additional factors beyond medication itself, including:

• Doctor and psychiatrist visits
• Therapy sessions
• Medication adjustments
• Lifestyle changes
• Time costs, including time off work for appointments or self-care practices
• Transportation
• Supportive programs or resources

Considering these costs can help you budget realistically and identify areas where extra support or financial planning may be needed.

Cost-Saving Strategies for Those Without Insurance

If you don't have insurance, there are several ways to save on medication costs:

• Use Prescription Discount Cards: Platforms like GoodRx, SingleCare, and RxSaver offer discounts at many pharmacies, including CVS, Walmart, Rite Aid, and Walgreens, with savings of up to 80% off the original retail price.
• Compare Pharmacy Prices: Use websites or apps to compare prices at nearby locations to find the best deal.
• Look for Pharmaceutical Assistance Programs: Many drug manufacturers have patient assistance programs that offer discounts or free medications to eligible individuals. Check the manufacturer’s website or ask your pharmacist. Examples include:

Manufacturer: Abbvie

Program: myAbbVie Assist Program

Manufacturer: Pfizer

Program: Pfizer RxPathways

Manufacturer: Takeda

Program: Patient Services & Assistance

• Use Mail-Order or Online Pharmacies: Some online and mail-order pharmacies offer lower prices, especially for a 90-day supply. Make sure the pharmacy is reputable and accredited.
• Check Local Health Clinics: Some clinics have sliding scale fees or discounts on prescriptions. Federally qualified health centers (FQHCs) and community health centers may also offer reduced prices.
• Apply for State Assistance Programs: Some states offer prescription assistance programs for low-income individuals without insurance. Check if your state has options available.

Finding the right strategy might require a little research, but the savings can make a real difference.

Takeaway

Anxiety medications come in different forms, each designed to address specific symptoms and needs. You might come across options like SSRIs, SNRIs, benzodiazepines, beta-blockers, or TCAs, and the prices for these can vary quite a bit.

If you have insurance, what you’ll pay depends on factors like copays, deductibles, and your plan’s coverage. Generic medications are often much more affordable, and some might even be fully covered, but brand-name options tend to come with higher costs.

If you don’t have insurance, there are still ways to save. You can look into discount cards, compare prices at different pharmacies, or explore assistance programs to find an option that works for your budget.

FAQs on How Much Are Anxiety Meds

Are there cost-effective alternatives to anxiety medication?

Yes. Exercise, for example, can help reduce anxiety by boosting endorphins that improve mood and sleep. Meditation and deep breathing exercises are free and can be done in just 15 minutes to promote relaxation. Chamomile, available as tea or inexpensive supplements, has shown potential in easing anxiety symptoms, especially for GAD. Aromatherapy with essential oils like lavender, jasmine, and chamomile may also provide relief, offering an affordable option for managing anxiety symptoms at home.

Are there free samples available for anxiety medications?

Yes, some doctors may have free samples of brand-name anxiety medications, provided by pharmaceutical companies that distribute new drug samples to clinics. Ask your doctor if they have any samples you can try before filling a full prescription.

Can I use Health Savings Account (HSA) funds to pay for anxiety medications?

Yes, you can use HSA funds to pay for prescribed anxiety medications, including common treatments like SSRIs and SNRIs. These medications are only eligible for reimbursement with a valid prescription. Be sure to keep receipts and documentation of your prescription for accurate record-keeping.