Medicare Coverage, Generics, and Pricing for Xarelto Prescriptions
In 2025, many Medicare Part D prescription drug plans and Medicare Advantage plans that include drug coverage will cover Xarelto, a brand-name anticoagulant, subject to certain conditions.
Xarelto is often classified as a specialty or high-cost drug, so most plans require prior authorization to ensure appropriate use. There might be quantity limits or step therapy requirements, such as needing to try other anticoagulants first. It's essential to note that coverage depends on filling prescriptions through the plan’s network pharmacy.
Several major Medicare Part D and Medicare Advantage plans that cover prescription drugs include Xarelto on their formularies. For instance, Kaiser Permanente Medicare Part D Prescription Drug Plan, Anthem Medicare Preferred Part D Prescription Drug Plan, People's Health Medicare Part D plans, and HAP Medicare Advantage plans may offer coverage for Xarelto, but always check the specific plan’s drug list to confirm coverage and any restrictions.
To find the Medicare Part D or Medicare Advantage plans that cover Xarelto in your area, review the official plan formularies for 2025 on insurer websites or use Medicare’s plan finder tool. Confirm if Xarelto requires prior authorization or other restrictions, and contact the plan’s member services for confirmation of coverage and any requirements.
The manufacturers list the full price of Xarelto at $561.31 per month, but offer a payment program where people pay between $10 and $85 per month in out-of-pocket costs depending on their insurance coverage. Currently, there are no generic alternatives to Xarelto.
It's important to remember that Xarelto is not covered by Original Medicare (Part A and Part B), and Medigap plans do not provide additional coverage for prescription medications, including Xarelto. However, if a person has prescription drug coverage through a Part D or Medicare Advantage plan, and the drug is on the formulary, Medicare will cover the cost of Xarelto.
Xarelto is an FDA-approved prescription anticoagulant used to treat and prevent deep vein thrombosis (DVT), pulmonary embolisms (PE), and reduce stroke risk in people with atrial fibrillation (AF). Xarelto oral tablets come in strengths of 2.5 mg, 10 mg, 15 mg, and 20 mg.
For more resources to help navigate medical insurance, visit the Medicare hub. It's always recommended to consult with a healthcare provider or the plan's member services for personalised advice regarding Xarelto coverage and usage.
Xarelto may also help reduce the risk of severe cardiovascular events in conditions such as coronary artery disease and peripheral artery disease. However, it's crucial to note that Xarelto is not recommended for people with kidney and liver problems or who have an artificial heart valve. Some pharmacies may provide coupons toward the cost of the drug, which may be used with Medicare coverage.
In summary, most major Medicare Part D and Medicare Advantage plans covering prescription drugs include Xarelto, but coverage comes with prior authorization and quantity limits—always verify by reviewing the 2025 specific plan formulary and coverage rules before enrolling or filling a prescription.
- Health organizations might find it helpful to know that Xarelto, a brand-name anticoagulant, is likely to be covered by some Medicare Part D and Medicare Advantage plans with drug coverage in 2025, subject to prior authorization and certain conditions.
- In the realm of health-and-wellness, it's significant to note that Medicare insurance, particularly Medicare Advantage plans and certain Medicare Part D plans, may offer coverage for Xarelto, an anticoagulant used for treating and preventing deep vein thrombosis, pulmonary embolisms, and reducing stroke risk in people with atrial fibrillation.
- For those researching the intersection of science and healthcare, it's worth mentioning that Xarelto, a high-cost drug, will be covered by some Medicare Part D and Medicare Advantage plans in the field of healthinsurance, but such coverage will come with conditions like prior authorization and quantity limits.
