Medicare Coverage for Xarelto in 2025: Costs, Plans, and Payment Assistance Options

In 2024, most Medicare prescription drug plans include coverage for blood thinners such as Xarelto. To benefit from this coverage, you must enroll in a Medicare Part D plan or a Medicare Advantage plan that incorporates Part D drug coverage.

Xarelto, the brand name for rivaroxaban, is a prescription anticoagulant widely prescribed to patients at risk of serious blood clot formation. It offers the convenience of fewer blood tests and dosage adjustments compared to other anticoagulants. However, without a generic alternative, its cost can be significant for those paying out-of-pocket.

Medicare prescription plans can substantially reduce the expense of Xarelto if you have appropriate drug coverage. Both Medicare Part D and Medicare Advantage (Part C) plans typically include this medication, lowering your costs compared to paying cash.

When Does Medicare Cover Xarelto?

Medicare covers Xarelto for most approved medical conditions. Around 96% of commonly prescribed medications, including Xarelto, are featured on Medicare drug plan formularies—a list of medications covered by the plan. Coverage requires a doctor’s prescription for conditions such as deep vein thrombosis (DVT) or stroke prevention.

Which Medicare Parts Cover Xarelto?

Your coverage depends on the Medicare plan you hold. Prescription drug coverage is offered through specific parts:

• Medicare Part A: Hospital insurance covers medications like Xarelto only during inpatient stays but not after discharge.
• Medicare Part B: Medical insurance covers doctor visits and outpatient services but does not cover prescriptions.
• Medicare Part C (Medicare Advantage): Combines Parts A and B coverage and often includes Part D drug coverage, which generally covers Xarelto.
• Medicare Part D: Prescription drug plans that cover Xarelto if it is listed in their formulary.
• Medicare Supplement (Medigap): Helps pay out-of-pocket costs for Medicare services but does not cover prescription drugs like Xarelto.

Cost of Xarelto: What to Expect in 2024

The retail price for a 30-day supply of Xarelto ranges from approximately $542 to $618, depending on the pharmacy. Your actual cost will vary based on your Medicare plan’s coverage and copayment structure.

Payment Assistance for Xarelto

If you find Xarelto’s cost burdensome, consider manufacturer coupons from Johnson & Johnson Innovative Medicine, which may reduce copays significantly for commercially insured patients. For those with Medicare, copays may be around $89 per month for a 30-day supply or $250 for a 90-day supply.

Use Medicare’s plan finder tool by entering your ZIP code and current prescriptions to compare local Medicare Advantage and Part D plans that cover Xarelto and to estimate your copayments.

Summary

Xarelto is a vital medication for preventing blood clots and strokes. Medicare offers coverage for Xarelto through Part D and most Medicare Advantage plans, making it more affordable. Ensure your plan includes Xarelto in its formulary and shop for plans using the official Medicare website to find the best coverage and pricing options in your area.

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