How much does Vraylar cost with Medicare?

In this article:

• How Medicare covers prescription drugs
• Does Medicare cover Vraylar?
• What is the cost of Vraylar on Medicare?
• Vraylar coupons for Medicare
• Other ways to save on Vraylar

In this article

• How Medicare covers prescription drugs
• Does Medicare cover Vraylar?
• What is the cost of Vraylar on Medicare?
• Vraylar coupons for Medicare
• Other ways to save on Vraylar

Vraylar is an atypical antipsychotic drug commonly prescribed for the treatment of schizophrenia and bipolar disorder, and it can also be used to treat other psychiatric disorders. 

It’s typically covered under commercial health insurance plans as well as Medicare and Medicaid. Medicare coverage of Vraylar falls under Medicare Part D prescription drug coverage, and understanding how much you’ll pay for Vraylar with Medicare can be a little confusing. Based on your plan and several other factors, your out-of-pocket costs for Vraylar may change throughout the year. On top of that, Part D is undergoing changes in 2025 that will reduce drug costs for Medicare users, so that will also affect your costs moving forward.  

Without insurance, Vraylar costs nearly $2,000 for a 30-day supply, but that doesn’t mean you’ll pay that much monthly with Medicare. Here’s what you can expect to pay.

How Medicare covers prescription drugs

Prescription drugs are covered by Medicare under Part D, an optional add-on for people with other types of Medicare coverage, like Parts A and B. Medicare Advantage plans (Part C) typically provide prescription drug coverage, too.

How much help you get, though, is determined by which drug plan you have, as well as things like your monthly premium, deductible, copays, and coinsurance, as well as which phase of annual drug coverage you are in—the deductible phase, initial coverage period, coverage gap (donut hole), or catastrophic coverage phase. Medicare Part D beneficiaries enter the “donut hole” when their total drug costs for a calendar year add up to a predetermined limit, at which point their copay becomes a fixed 25% of the cost of the drug. 

Finally, Medicare Part D plans put all covered prescription drugs into a tier system, which also determines coverage and associated costs. Lower-tier drugs on a plan’s formulary (or list of medications) typically have less expensive copays, while higher-tier drugs usually cost more.  

Does Medicare cover Vraylar?

According to Erika Gray, Pharm.D., cofounder of Toolbox Genomics, Vraylar is typically covered under Medicare Part D prescription drug plans. However, she notes that most Medicare drug plans have their own formulary, or list of drugs that are covered, and not all Part D plans have the same requirements or restrictions (like prior authorization) for Vraylar. You should check with your specific Medicare plan to verify coverage.

What is the cost of Vraylar on Medicare?

Because Medicare coverage goes through several phases during a calendar year, it’s difficult to estimate the average cost of Vraylar on Medicare. But you may be able to do some calculations yourself if you have information about your specific Medicare Part D plan. 

“Since Vraylar is typically a Tier 4 medication with most plans, the deductible will likely apply,” says Medicare expert Alexandria Roland. “This means you’ll pay the full cost of the drug until the deductible is met, and then you’ll have a coinsurance.”

That coinsurance, Roland says, could range from 35%–50% of the drug cost, averaging out to a few hundred dollars per month in 2024. However, once you enter the coverage gap, your monthly costs will change again. Roland says your cost-sharing caps out at 25% of the drug cost, so the amount you pay during this coverage phase will be lower.

Keep in mind that the thresholds for your deductible and coverage gap change year-to-year on Medicare, and that new changes are coming in 2025 that will benefit patients. Thanks to the Inflation Reduction Act, people on Medicare Part D will have their annual out-of-pocket costs capped at $2,000 and will see the coverage gap completely eliminated.

Vraylar coupons for Medicare

There are ways to save on Vraylar, but not all are available to Medicare beneficiaries. For example, the drug’s manufacturer, AbbVie, offers a savings program called VrayPay that can bring the price of Vraylar down to as little as $5 per 30-day supply, but it’s only available to people with commercial insurance, not people on Medicare. 

However, if your Medicare Part D copay is too high or if Vraylar isn’t on your plan’s drug formulary, you can choose not to use your Medicare coverage and instead pay for your prescription using a SingleCare prescription discount card. With the prescription discount card, you get access to coupons from over 35,000 pharmacies across the country. Depending on your choice of pharmacy, you may be able to pay $1,298 for 30, 1.5 mg capsules instead of the average retail price of $1,996 with a SingleCare coupon. However, you can’t double up on savings by using your Medicare coverage plus another type of discount. 

Other ways to save on Vraylar

Regardless of your insurance coverage, there are other ways to save on Vraylar that don’t require using a coupon or discount. 

Medicare Extra Help

“The Medicare Extra Help program is one option for making Vraylar more affordable,” Dr. Grey says, as it could lower your cost for a 30-day supply of Vraylar to $11.20 or less.

You may automatically qualify for Extra Help, or you may need to submit an application through the Social Security Administration. Eligibility is based on income and resource limits (e.g., money in stocks, bonds, and bank accounts).

“If you are approved, Extra Help can lower your premium and cost-sharing,” Roland says. “It eliminates the plan’s deductible and donut hole, which could save you thousands of dollars during the year.” 

Vraylar alternatives

There is no generic version of Vraylar, which contributes to its higher-than-average cost for an antipsychotic drug. However,  if the cost of Vraylar is not affordable for you and you’re unable to use any other savings strategies, talk to your healthcare provider. There may be another type of antipsychotic medication you can take that’s more affordable. For example, Seroquel retails at around $250 for a 30-day supply and also treats symptoms of schizophrenia, bipolar disorder, and other psychiatric disorders.

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