Xarelto® Medicare Coverage

Xarelto®
Chemical name: Rivaroxaban

Typical dosage: 20mg

Typical type: Tablet1

Xarelto® is a medication typically used to treat or prevent VTE, prevent systemic embolism in atrial fibrillation and reduce the risk of CV events in coronary artery disease. Xarelto is a brand name only medication and is available as an oral tablet.

Xarelto is a prescription medication that contains the active ingredient Rivaroxaban. It is taken twice daily anywhere from 3 months to indefinitely.

Xarelto is a blood thinner that inhibits factor Xa in the blood to inhibit platelets from creating blood clots.

There are minimal side effects with Xarelto, but patients may experience more bleeding than usual while taking this medication.  

Does Medicare cover Xarelto?

Yes! 98% of Medicare Advantage plans and Medicare Part D plans cover Xarelto.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 Xarelto.

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.

Average costs for Xarelto 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 – $508 $19 – $508

Additional information

You may bleed more easily while taking Xarelto. Be careful to avoid injury. A soft toothbrush and electric razor may help reduce bleeding.

If you have a hard fall, or hit your head call your doctor right away even if you feel okay.

If you start taking Xarelto, do not stop this medication without consulting your doctor. Stopping Xarelto before you are supposed to may raise the chance of blood clots.

While very rare, patients who have any type of spinal or epidural procedure are more likely to have bleeding problems around the spine while on this drug. This risk is raised in people who have other spinal problems, a certain epidural catheter or have had spinal surgery.

Xarelto is not recommended in patients with prosthetic heart valves or significant rheumatic heart disease.

 

 

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.