Repatha Medicare Coverage

Repatha lowers bad cholesterol called LDL in adults with cardiovascular disease to reduce their risk of heart attack and stroke. Repatha can be used with other cholesterol-lowering agents for additional LDL lowering.

It is an injection that is given under the skin (subcutaneously) every 2 weeks or monthly. It comes in a single-dose prefilled autoinjector, but the dose that is right for you will be determined by your provider.

Common side effects with this medication include symptoms of cold or flu, back pain, higher blood sugar levels and redness or bruising at the injection site.

How much does Repatha cost with Medicare?

Repatha 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 Repatha?

According to GoodRx, 79% of Medicare Advantage plans and Medicare Part D plans covered Repatha in 2023.¹

• Medicare Advantage plans or Part D plans that cover Repatha 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 Repatha. 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

High cholesterol, specifically higher levels of LDL cholesterol, is bad because it builds up in the arteries. This decreases blood flow to the heart and body, increasing the risk of having a heart attack or stroke.

Repatha works differently than standard cholesterol medications called statins. Repatha acts by helping the liver clear LDL cholesterol from the blood through limiting the actions of PCSK9, a protein in the liver that inhibits the liver from doing this job.

Repatha taken together with a statin can dramatically lower LDL.

This medication should not be injected with other injectable medications at the same injection site. Serious allergic reactions have occurred to this medication.

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.