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.

Does Medicare cover Repatha?

Yes! 74% of Medicare Advantage plans and Medicare Part D plans cover Repatha.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 Repatha.

Or call 1-800-557-6059 1-800-557-6059 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 Repatha with Medicare drug coverage¹

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

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.