How much does Rexulti cost with Medicare?
**The cost of Rexulti with Medicare varies depending on several factors, such as the specific Medicare plan, the dosage prescribed, and whether the drug is covered under the plan’s formulary. While it is difficult to provide an exact cost without considering these variables, we will provide a general overview of factors that may influence the price.**
Rexulti (generic name: brexpiprazole) is a prescription medication used to treat mental health conditions including schizophrenia and major depressive disorder. The cost of Rexulti can be a significant factor for individuals relying on Medicare for their healthcare coverage.
1. Is Rexulti covered by Medicare?
Rexulti is approved by the U.S. Food and Drug Administration (FDA) and may be covered by certain Medicare Part D plans, which provide prescription drug coverage.
2. What determines the cost of Rexulti with Medicare?
The cost of Rexulti with Medicare is influenced by various factors, including the specific Medicare plan and the chosen pharmacy. Additionally, the dosage and strength prescribed, as well as whether the drug is considered a “brand name” or “generic,” can affect the cost.
3. How does Medicare Part D coverage work?
Medicare Part D plans are provided by private insurance companies approved by Medicare. These plans often have different formularies, which are lists of covered medications. The formulary determines the cost-sharing responsibilities of the beneficiary.
4. Are all Medicare Part D plans the same regarding Rexulti coverage?
No, Medicare Part D plans can differ in terms of which prescription drugs they cover, including Rexulti. It is important to review the formulary to determine if Rexulti is covered under a specific plan.
5. What are the cost-sharing responsibilities under Medicare Part D?
Cost-sharing responsibilities refer to the amount beneficiaries pay out-of-pocket for medications. These costs typically involve a combination of deductibles, copayments, and/or coinsurance.
6. Can the cost of Rexulti change from year to year?
Yes, the cost of medication can fluctuate annually due to changes in the Medicare plan and formulary. This is why it is essential to review the coverage and costs each year during the Medicare Annual Enrollment Period.
7. How can I find out the cost of Rexulti specific to my Medicare plan?
To determine the cost of Rexulti with Medicare, it is crucial to review the formulary of the specific Medicare Part D plan. This can typically be found on the plan’s official website or by contacting their customer service.
8. Are there any financial assistance programs available for Rexulti?
Some manufacturers offer patient assistance programs that can help reduce the cost of prescription medications, including Rexulti. These programs may have specific eligibility criteria, so it’s essential to check with the manufacturer or program directly.
9. Can I use a Medicare Part D plan and an assistance program together?
In some cases, it is possible to utilize both a Medicare Part D plan and an assistance program to further reduce the cost of medications like Rexulti. However, each program has its own rules and requirements, so it is important to confirm eligibility and coverage.
10. Are there any generic alternatives to Rexulti?
Currently, there is no generic alternative available for Rexulti, as it is still under patent protection until 2022. However, after patent expiration, generic versions may become available at a more affordable cost.
11. What if Rexulti is not covered by my Medicare plan?
If Rexulti is not covered by the Medicare Part D plan, beneficiaries have several options. They can consult with their healthcare provider to discuss alternative medications, file an exception request with the plan, or explore other coverage options.
12. Can I change my Medicare plan during the year to reduce the cost of Rexulti?
Generally, most Medicare beneficiaries can only change their Part D plans during the Annual Enrollment Period, which occurs from October 15th to December 7th. However, some individuals may qualify for Special Enrollment Periods under specific circumstances, which could allow plan changes outside the standard enrollment period.
In conclusion, the cost of Rexulti with Medicare can vary depending on several factors such as the specific Medicare plan, formulary coverage, and pharmacy chosen. It is crucial to review the formulary of the Medicare Part D plan and consult with the plan provider or pharmacy to determine the exact cost of Rexulti. Additionally, exploring patient assistance programs and considering alternatives may help reduce the out-of-pocket expenses associated with this medication.