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How much does Rinvoq cost with Medicare?

Medicare beneficiaries may see lower Rinvoq costs in 2025 thanks to new prescription caps and flexible payment plans
Gerardo Sison medical writer headshot
By | Jul. 7, 2025
Spilled bottle of white tablets: How much does Rinvoq cost with Medicare?

Key takeaways

  • Starting in 2025, Medicare caps out-of-pocket prescription costs at $2,000 and allows monthly payment plans to help manage expenses.

  • While Medicare Part D often covers Rinvoq, coverage may depend on prior authorization, step therapy, or quantity limits.

  • Medicare patients typically pay far less than Rinvoq’s list price, but final costs depend on the plan, pharmacy, and deductible.

  • Programs like Medicare Extra Help and AbbVie’s patient assistance may help reduce or eliminate Rinvoq costs for eligible patients.

In this article:

Many people rely on Rinvoq (upadacitinib) to help manage several chronic conditions, including rheumatoid arthritis, psoriatic arthritis, eczema (atopic dermatitis), and ulcerative colitis. Depending on the condition treated, Doctors or healthcare providers may prescribe it for adults and children as young as 2 years old. While Rinvoq may be a lifeline for those struggling with their condition, it can come with some uncertainty about costs, especially for those with Medicare.

New changes to Medicare in 2025

Medicare is a federal health insurance program developed for people 65 and older and younger individuals with certain disabilities. It provides access to hospital care, medical services, and prescription drug coverage. Many people use Medicare Part D or Medicare Advantage plans to help pay for their medications.

Beginning in 2025, important changes have taken effect for Medicare’s prescription drug benefits:

  • The annual out-of-pocket maximum for covered prescription drugs under Part D will be capped at $2,000, including deductible costs. This cap will apply automatically to everyone enrolled in a Medicare Part D plan.
  • Medicare will offer a Prescription Payment Plan (MPPP) that lets you spread out your out-of-pocket costs with monthly payments instead of all at once. To sign up for the MPPP, you must contact your Part D plan provider for help with enrollment.

With these updates, prescription medications may be more affordable and predictable for Medicare beneficiaries. If you have questions or want to explore your options, visit www.medicare.gov or speak with your plan provider for support.

Does Medicare cover Rinvoq?

Many Medicare plans may cover some or most of the cost of a Rinvoq prescription. However, out-of-pocket costs can vary, and insurance coverage may depend on the specific condition you’re treating, such as Crohn’s disease, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. Some plans may cover Rinvoq for certain conditions only, so it’s best to check your plan’s benefits or talk to your pharmacy about coverage. 

Most Medicare Part D plans list Rinvoq on their drug formularies, but some insurance plans require specific steps for coverage. These may include:

  • Prior authorization: Before approving Rinvoq, the insurance company may ask the prescribing doctor to provide detailed medical information. This extra documentation can help the insurer decide if Rinvoq is medically necessary. Approval can take several days, and without it, the plan might not cover the medication.
  • Step therapy: Some Medicare Part D plans require patients to try one or more alternative medications before they will cover Rinvoq. This process is called step therapy and encourages the use of less costly drugs when available. If those initial treatments don’t work or cause side effects, the doctor can request approval for Rinvoq. Patients and healthcare professionals may need to provide records showing that the previous medications were tried and failed.
  • Quantity limits: Many plans set a maximum amount of Rinvoq extended-release tablets that can be dispensed within a certain time frame, such as a 30-day supply per month. The doctor can request an exception if you need more than the allowed amount due to medical reasons. The insurance company will review the request and decide whether to approve extra quantities.

Keep in mind that Medicare does not cover Rinvoq under Medicare Part A or B, as these parts typically don’t cover most outpatient prescription drugs. Only Part D and some Medicare Advantage plans include this type of drug coverage.

How much does Rinvoq cost with Medicare?

Medicare plans may have their own copay, deductibles, and coverage rules. Without insurance, the list or cash price of a 30-day supply of Rinvoq averages around $8,617. However, most people with Medicare don’t pay this amount.

According to the manufacturer’s website, the average person with Medicare may pay $0 to $2,000 monthly for Rinvoq, but out-of-pocket costs can vary. Those with Medicare Low Income Subsidy (LIS), also known as Medicare Extra Help, generally pay $12.15 or less per dose. 

Similar to commercial insurance, prescription drug coverage through Medicare usually works like this:

  • Deductible period: First, you may need to pay the full negotiated price for your covered prescription drugs until you meet your Medicare Part D deductible. This is a yearly amount you pay out of pocket before your plan begins to help. For 2025, no plan can have a deductible higher than $590, and some plans have no deductible.
  • Initial coverage period: After you’ve met your deductible, your plan helps pay for your covered prescriptions. You pay a copay or coinsurance for each drug, and your plan covers the rest. This continues until your total drug costs reach $2,000 in 2025. The costs that count toward this limit include what you paid for the deductible, your share during this period, and certain payments made by others on your behalf (like Extra Help or assistance programs).
  • Catastrophic coverage: Once your out-of-pocket costs for covered drugs reach $2,000, you enter catastrophic coverage. From this point on, you pay $0 for covered prescriptions for the rest of the year.

Factors like which Medicare plan you have, which pharmacy you use, and meeting a deductible can affect the monthly price you pay. If you have questions about costs, rebates, or reimbursements, you can call 1-800-2RINVOQ for help from the manufacturer.

Rinvoq assistance for Medicare patients

In many cases, it can be hard to pay for Rinvoq, even with Medicare. Whether it’s due to high out-of-pocket costs or other limits, having Medicare doesn’t always mean getting the medication you need when you need it. Still, there are some ways to potentially help manage the costs with Medicare.

SingleCare coupons

SingleCare is a free prescription savings service that may help lower the cost of Rinvoq, even if you have Medicare. Although you can’t use SingleCare with your Medicare plan at the same time, you can choose to use a SingleCare coupon instead of your insurance if it offers a better price. 

Prices can vary by pharmacy, so comparing costs online or through the SingleCare app is a good idea. After printing or downloading your discount card, you can show it to the pharmacist when filling your prescription. Keep in mind that discounts through SingleCare don’t count toward your Medicare deductible or out-of-pocket maximum.

Medicare Extra Help

Medicare Extra Help is a federal program that helps increase patient access to prescription drugs for those with Medicare and limited income. It could help reduce or eliminate your monthly premiums, annual deductibles, and co-pays for medications like Rinvoq if you qualify. 

You can apply online or through the Social Security Administration. Eligibility criteria are based on your income and assets. If you’re not sure you qualify, it’s recommended to check, as many people are eligible but don’t apply. Getting Extra Help may also make you automatically eligible for other savings programs.

Manufacturer coupons 

AbbVie offers the Rinvoq Complete Savings Card that helps lower costs for commercially insured patients. Unfortunately, this program is not available to those with Medicare, Medicaid, or other government-funded insurance. However, AbbVie still encourages Medicare patients to contact them for support. 

An insurance specialist can help review your situation and check for other options. If you’re not eligible for copay assistance, AbbVie may refer you to programs like Extra Help or patient assistance programs. In some cases, you may still qualify to receive Rinvoq at no cost.

Patient assistance programs

AbbVie‘s myAbbVie Assist program may offer free Rinvoq to eligible patients who meet specific income and insurance criteria. Medicare beneficiaries may qualify if they have limited prescription coverage and show financial need. However, if your income is below 150% of the Federal Poverty Level (FPL), you must first apply for and be denied Medicare’s Extra Help program before being considered for myAbbVie Assist. 

The application process is free and involves completing forms with your healthcare provider. If approved, you can receive Rinvoq at no cost, including free shipping and no co-pays. For assistance or to apply, contact AbbVie at 1-800-222-6885 or visit their patient assistance website. 

Check for free samples

While AbbVie does not publicly advertise free samples of Rinvoq for Medicare patients, you might want to discuss this option with your healthcare provider. Doctors may have access to starter supplies or sample packs, which can help you start your treatment plan while exploring longer-term financial assistance. While these are not a long-term solution, they may help if you’re waiting for another form of assistance to be approved or need medicine in a pinch.

Alternative medications

There is currently no generic version of Rinvoq, so it’s not possible to choose a cheaper generic alternative. However, you can ask your doctor for medical advice about possible lower-cost medications that may treat similar conditions.

For rheumatoid arthritis, psoriatic arthritis, or ulcerative colitis, other Janus kinase (JAK) inhibitors, such as Xeljanz (tofacitinib) and Olumiant (baricitinib), are commonly prescribed and may have better Medicare coverage than Rinvoq. For atopic dermatitis, Dupixent (dupilumab) is an FDA-approved alternative that is often covered by Medicare Part D plans. 

If you’re finding it difficult to manage the costs of Rinvoq with Medicare or you just want to see if it’s possible to save more, you have various options at your disposal. It’s best to contact your plan, the manufacturer’s support line, or your pharmacist for input. They can help you find the best option.

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