Brilinta (Ticagrelor) Medicare Coverage

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.

How much does Brilinta cost with Medicare?

Brilinta coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Brilinta?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Brilinta in 2023.¹

• Medicare Advantage plans or Part D plans that cover Brilinta include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• 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. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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.

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.