Entresto® Medicare Coverage

Entresto®
Chemical name: Sacubitril/Valsartan

Typical dosage: 24mg

Typical type: Tablet1

Entresto® is a medication typically used to treat heart failure. It is a brand name only medication and is available as an oral tablet.

Entresto is a prescription medication that contains the active ingredients Sacubitril and Valsartan.

Entresto is taken twice daily and the dose is usually increased after 2-4 weeks as tolerated. Entresto relaxes blood vessels so that blood can flow more easily, which makes it easier for the heart to pump blood to the body.

The most common side effects of Entresto include low blood pressure, increased potassium, and a dry cough.

Does Medicare cover Entresto?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Entresto.1

  • 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.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 Entresto.

Find Medicare Advantage plans with drug coverage

Compare Plans

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 Entresto with Medicare drug coverage1

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

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.
$42 – $573 $19 – $550

Additional information

You may not be able to feel the effects of Entresto. Do not stop taking this medicine unless instructed by your doctor.

Low blood pressure can occur with Entresto. Call your doctor if you feel dizzy, weak, or feel like passing out.

Call your doctor if you experience signs of kidney problems including inability to pass urine, change in how much urine is passed, blood in the urine or weight gain.

You should also call your doctor if you have signs of high potassium levels including an abnormal heart beat; change in thinking clearly and with logic; feeling weak, lightheaded or dizzy; feeling like passing out; numbness, tingling or shortness of breath.

Entresto may be combined with other medications to adequately control your heart failure. Entresto should not be used with ACE-inhibitors such as losartan, valsartan or Irbesartan. You may have to delay starting Entresto if you have recently been taking an ACE-inhibitor. 

 

 

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.