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Key takeaways
Medicare Part D generally covers Repatha, but costs vary based on each plan’s formulary tier and requirements like prior authorization or step therapy.
Some Medicare Advantage (Part C) plans also cover Repatha, while Part B or Part A may apply if it’s administered in a clinical or inpatient setting.
Medicare patients may reduce costs through discount cards, Extra Help, patient assistance programs, or by considering lower-cost alternatives.
Repatha (evolocumab) is a prescription drug approved by the U.S. Food and Drug Administration (FDA) to help adults and children aged 10 and up lower “bad” cholesterol (low-density lipoprotein cholesterol, or LDL-C) levels in the blood. Healthcare providers typically prescribe the injectable medication, along with dietary changes, to help people reduce the risk of heart attack, stroke, and other cardiovascular events.
For Medicare beneficiaries, the cost of Repatha varies depending on whether the beneficiary has drug coverage, the type of drug plan they have, and the tier on which the heart medication is listed in the plan’s drug formulary. Costs also may vary depending on a beneficiary’s income and assets.
Does Medicare cover Repatha?
“Medicare Part D generally does cover Repatha, but coverage specifics depend on the individual plan’s formulary and tier placement,” says Elizabeth Rubin Ribak, MD, a board-certified emergency medicine physician and clinical advisor at Embers Recovery in Phoenix, Arizona. “Most Part D plans list Repatha as a specialty-tier drug, which often means higher copays or coinsurance compared to generic medications.” Most Medicare Advantage (Part C) plans also cover a single-dose SureClick Repatha autoinjector as part of that plan’s drug coverage portion.
If you have Original Medicare (Part A and Part B), and your healthcare provider administers Repatha in their office or clinic, your Part B insurance may cover the medication costs. If the drug is administered during your hospital or skilled nursing facility stay, Part A may cover it. In these specific instances, the cost sharing will follow Part A or Part B cost sharing rules.
If you’re unsure if your Medicare Part D plan covers Repatha, you can check its drug formulary (a list of approved medications). On a drug formulary, medications are organized into four cost tiers, which health plans use to guide beneficiaries toward the most cost-effective options. Repatha often lands on tier 3, meaning it’s a non-preferred, brand-name prescription drug with a higher copay.
Dr. Ribak adds that in many instances, people must receive prior authorization before their Medicare plan covers Repatha. Prior authorization (PA), also known as prior approval, pre-authorization, or pre-certification, is a standard health insurance process in which your healthcare provider has to document that a specific medical service, equipment, or medication—such as Repatha—is medically necessary on behalf of the patient. Prescription drugs that often require a PA have a high price tag, potential for misuse, or generic alternatives available.
Your Medicare insurance plan may also require step therapy before covering the cost of Repatha. Step therapy, also known as fail-first or step protocol, is another restriction in which your health insurance company may ask you to try cheaper medications (such as generics) before moving up to more expensive ones like Repatha.
How much does Repatha cost with Medicare?
The average list price for Repatha is about $793 for 2, 1 mL of 140 mg/mL syringes. According to Repatha’s manufacturer, Amgen, about 74% of Medicare beneficiaries pay $50 or less a month for the injectable medication. How much your copay will be for Repatha will depend heavily on your Medicare drug plan and whether you’ve reached your annual deductible. In 2026, no Part D prescription drug plans may have a deductible more than $615. In addition, the annual out-of-pocket maximum for Part D plans is $2,100. If you meet this amount in out-of-pocket expenses (not including premiums), you won’t pay anything further for Repatha or other covered prescription medications for the rest of the calendar year.
Save up to 80% on Repatha with SingleCare
Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.
Repatha assistance for Medicare patients
If your Medicare drug plan has high copays for Repatha or doesn’t cover the heart medication at all, there are other options you can explore to save money on your prescription.
Here are some strategies for getting financial assistance for Repatha as a Medicare recipient:
SingleCare discount card
A pharmacy savings card can help you lower the cost of your Repatha prescription. The SingleCare discount card is a free coupon that can help you save up to 80% on your prescriptions. With this savings card, you can pay $462 for 2, 1 mL of 140 mg/mL syringes at Kroger’s Pharmacy if Medicare doesn’t cover your Repatha prescription. This price is significantly lower than the list price of the heart medication ($793), saving you more than $300 in out-of-pocket costs.
If your Medicare drug plan covers Repatha but your copay is too high, using a SingleCare prescription discount card can often give you a lower copay than your insurance plan.
To get your discount, visit Repatha’s drug coupon page, choose your preferred pharmacy with the best deal (the card works at most major pharmacies), and print or download it to your phone or tablet. You’ll show the coupon card to your pharmacist to get your Repatha discount.
You should be aware that you cannot combine use of a discount card with your Medicare drug coverage. Also, any money spent out of pocket when using a discount card at your pharmacy will not count toward your Medicare Part D deductible or annual out-of-pocket maximum.
Medicare Extra Help
Many Medicare Part D recipients meet the eligibility requirements for Medicare’s Extra Help program. This federally-administered benefit for people with limited income and resources helps pay for copays, coinsurance, premiums, and deductibles.
Many people automatically receive Extra Help if:
- They have full Medicaid coverage
- Get assistance from their state to pay Part B premiums
- Receive Supplemental Security Income (SSI) payments from Social Security
If you don’t qualify for Extra Help automatically, you can apply online. If you qualify for Extra Help, you can expect to pay a lower copay for your Repatha medication to help manage high blood cholesterol levels.
Patient assistance programs
Several patient assistance programs are available to help Medicare recipients access their Repatha prescription. The Amgen Safety Net Foundation (ASNF) is a patient assistance program that helps people in financial need gain access to Amgen’s medications at no cost. Medicare recipients facing financial hardship who are not eligible for the Extra Help program can apply for ASNF.
Free samples at healthcare provider’s office
If you don’t have Medicare coverage for Repatha, ask your healthcare provider for a few free samples. While this isn’t a sustainable savings method per se, it can be helpful if you’re in a pinch and out of refills.
Repatha alternatives
Repatha is one of several cholesterol-lowering medicines available to help manage your cardiovascular health. In fact, many Medicare Part D and Medicare Advantage plans may cover cheaper alternatives to Repatha, helping lower a patient’s out-of-pocket costs.
Cheaper alternatives to Repatha
As previously mentioned, several substitute medications provide similar benefits to Repatha if you’re facing challenges with insurance coverage or high copays.
Below is a table of cheaper Repatha alternatives you and your healthcare provider can explore:
Cheap Repatha alternatives |
|||
|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Praluent (alirocumab) | $711 for 2, 1 mL of 75 mg/mL pens | $512 at Kroger’s | See latest prices |
| Lipitor (atorvastatin calcium) | $692 for 30, 40 mg tablets of generic Lipitor | $8 at Kroger’s | See latest prices |
| Crestor (rosuvastatin) | $361 for 30, 10 mg tablets of generic Crestor | $8 at Kroger’s | See latest prices |
| Colestid (colestipol Hcl) | $180 for 60, 1 gm tablets | $41 at CVS Pharmacy | See latest prices |
| True Vitamin B3 (niacin) | $26 for 500 mcg tablets | $5 at Walgreens | See latest prices |
| Nexletol (bempedoic) | $591 for 30, 180 mg tablets | $378 at Kroger’s | See latest prices |
| Tricor (fenofibrate) | $263 for 90, 160 mg tablets of generic Tricor | $19 at Kroger’s | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of 12/10/2025. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.
Before switching medications, please consult your healthcare provider to avoid potential drug interactions or any unwanted adverse effects, such as serious hypersensitivity reactions.
If you are facing financial hardships paying for Repatha injections or other prescription drugs, or have questions about the best treatment to manage your medical conditions, please consult your healthcare provider for medical advice
- How do drug plans work, Medicare.gov
- Cost and co-pay card information, Repatha
- Help with drug costs, Medicare.gov
- Extra Help with Medicare prescription drug plan costs, Social Security Administration
- Amgen Safety Net Foundation, Amgen Safety Net Foundation
- Elizabeth Rubin Ribak, MD of Embers Recovery