Brilinta (Ticagrelor) Medicare Coverage

Brilinta
Chemical name: Ticagrelor

Brand name: Brilinta

Typical dosage: 90mg

Typical type: Tablet1

Brilinta is a medication used to prevent heart attacks and to treat acute coronary syndrome (ACS). Brilinta is available as a brand name drug and is available as an oral tablet.

Brilinta is a medication that contains the active ingredient Ticagrelor. It is used to reduce the risk of death, heart attack and stroke in patients who have acute coronary syndrome (ACS) or a history of heart attacks.

Brilinta is an antiplatelet agent that prevents platelets in the blood from sticking together and creating clots. Brilinta can also reduce the rate of a clot in a stent. Brilinta is taken twice daily and is typically used for a year or more after a cardiovascular event.

Brilinta is typically well tolerated, but a common side effect of the medication is shortness of breath.

Does Medicare cover Brilinta or Ticagrelor?

Some Medicare Advantage plans and Medicare Part D plans may cover Brilinta.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Brilinta.

Find Medicare Advantage plans with drug coverage

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Brilinta with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Brilinta should be taken at the same time of day every day. If you can’t swallow the tablet, the tablet can be crushed, mixed with water and drank right away. Refill your glass with water, stir it and drink to make sure you received the whole dose.

Bleeding can happen while taking Brilinta, due to the decreased platelet clumping. Bleeding that goes untreated can be deadly. Avoid using Brilinta if you have problems with bleeding.

To reduce the risk of bleeding, do not take more than 100mg of aspirin per day.

Stopping Brilinta before your doctor instructs you to can increase your risk of heart attack, stroke and death. This risk is especially high if you have had a previous cardiac event.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.