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Xarelto assistance for Medicare patients

Learn more about Xarelto savings for Medicare patients
Lindsay Malzone writer headshot
By | Updated on Apr. 7, 2024 Medically reviewed by Scott Dershowitz, LMSW, CMC
Rx pill bottle: Xarelto assistance for Medicare patients

Key takeaways

  • Xarelto is a medication used to prevent blood clots, but Medicare patients need a Part D or Medicare Advantage plan with drug coverage to get it covered, as Original Medicare and Medigap do not cover prescription drugs.

  • The cost of Xarelto varies with Medicare, depending on the plan, dosage, and pharmacy, with options to reduce costs through coupons, especially since there’s no generic version in the U.S. yet.

  • Medicare beneficiaries can access assistance programs like SingleCare coupons and Medicare Extra Help to lower Xarelto’s out-of-pocket costs, with Extra Help providing significant savings and protection against the coverage gap.

  • Alternatives to Xarelto include other anticoagulant drugs and natural blood thinners, but patients should consult their physician before switching, and those whose Medicare plan doesn’t cover their medication have specific enrollment periods to change plans.

Xarelto is a blood thinner that’s used to treat or prevent blood clots by blocking the activity of certain clotting substances. Since age—particularly those 60 and older—is a risk factor for developing a blood clot, according to the American Society of Hematology, many Medicare beneficiaries are prescribed blood thinners like Xarelto. Fortunately, many Medicare prescription plans cover Xarelto and offer financial assistance for this prescription.

Does Medicare cover Xarelto?

Yes, many Medicare Part D and Medicare Advantage plans cover Xarelto. However, drug coverage varies by plan. It’s important to check the health plan’s formulary before enrolling in a Medicare prescription plan to ensure all your medications are covered. 

How much does Xarelto cost with Medicare?

The average cost of Xarelto without insurance is around $728 for 30, 20 mg tablets, according to SingleCare prescription data. 

The cost of Xarelto with Medicare depends on many factors, such as the dosage you’re prescribed, the plan you enrolled in, which coverage stage you’re in, your plan’s copay or coinsurance terms, whether your eligible for Extra Help, and the pharmacy you purchase the medication from. You can estimate your cost for Xarelto with your particular Medicare plan by using the Plan Finder tool.

Xarelto assistance for Medicare patients

Typically, you can find a generic version of a brand-name drug that helps lower the cost of prescription drugs. However, there is no generic alternative to Xarelto available in the United States. This is because the patent protection for the active ingredient found in Xarelto (rivaroxaban) was extended until August 2024 in the United States.

Fortunately, Xarelto coupons for Medicare patients and people without health insurance are available to help reduce the cost of the medication.

SingleCare coupons

The good news is that there are free coupons for Xarelto available through SingleCare. These coupons can save you money, even if you currently have Medicare or another type of insurance. 

The cost for Xarelto without insurance is around $728 for 30, 20 mg tablets. However, with SingleCare pharmacy coupons, you could pay $456 for 30, 20 mg tablets. 

There are situations where you can save more money by using SingleCare instead of your Medicare prescription drug plan. However, the amount you’ll pay with a SingleCare savings card will not count toward your Medicare deductible.

RELATED: Can I use SingleCare if I’m on Medicare? 

Medicare Extra Help

If you meet the low-income requirements or are dual-eligible for both Medicare and Medicaid, then you can get help paying for Xarelto on Medicare.

The Medicare Extra Help program will reduce your out-of-pocket costs for prescription drugs, eliminate your monthly Part D premium, and even eliminate or reduce your Part D annual deductible.

Some beneficiaries fall into the coverage gap, also known as the donut hole. During the donut hole, the beneficiary has a window where their prescription drug insurance coverage is limited. 

While in the donut hole, you’ll pay 25% of the cost of generic and brand-name drugs until you reach $8,000 in out-of-pocket costs for covered drugs. Once you reach this amount, you’ll fall into the catastrophic phase of Part D, where you will no longer incur any cost-sharing for your medications. If the donut hole is something you’re concerned with, you can find peace of mind knowing Extra Help will protect you from the coverage gap. 

Manufacturer rebates and savings programs

Xarelto coupons may be available through the manufacturer. Contact Janssen Pharmaceuticals, Inc. for additional information about their offerings, such as Xarelto withMe Coverage Gap Support, and to find out if you qualify for financial assistance.

Xarelto alternatives

There are a few anticoagulant drugs that can be used in place of Xarelto. The most common include Eliquis, warfarin, Pradaxa, Plavix, and Brilinta. Other less common anticoagulant drugs include Angiomax (bivalirudin), argatroban, Bevyxxa (betrixaban), Effient (prasugrel), Iprivask (desirudin), Savaysa (edoxaban), and unfractionated heparin. 

There are also a few natural alternatives to Xarelto that can help reduce the risk of blood clots and cardiovascular disease. These natural blood thinners include garlic, turmeric, ginger, vitamin E, and omega-3 fatty acids. 

Make sure to always consult with your physician before switching to any Xarelto alternative.

RELATED: Eliquis vs. Xarelto

What if my Medicare prescription drug plan doesn’t cover Xarelto?

If your Medicare prescription drug plan doesn’t cover your medications, there are a few enrollment windows to make changes.

If you have prescription drug coverage through a Medicare Advantage plan, you can switch plans two times during the year:

  • Medicare Annual Enrollment Period (Oct. 15-Dec. 7)
  • Medicare Advantage Open Enrollment Period (Jan. 1-Mar. 31)

If you have a Part D prescription drug plan, the only annual enrollment window you can make changes to is during the Annual Enrollment Period in the fall. 

You may also be able to switch plans outside of one of these enrollment windows if you had a change in circumstance and met the eligibility requirements for a Medicare Special Enrollment Period.

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