{"id":628536,"date":"2024-06-10T13:23:42","date_gmt":"2024-06-10T17:23:42","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628536"},"modified":"2025-12-12T09:35:31","modified_gmt":"2025-12-12T14:35:31","slug":"does-medicare-cover-trelegy","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-trelegy\/","title":{"rendered":"Does Medicare cover Trelegy Ellipta?"},"content":{"rendered":"

For nearly 4.6% of adults in the United States, the coughing, wheezing, and difficulty breathing of <\/span>chronic obstructive pulmonary disease (COPD)<\/span><\/a> is a daily battle. Fortunately, drugs like <\/span>Trelegy Ellipta<\/span><\/a> can help. Trelegy is a combination inhaler that contains three ingredients to prevent and control the symptoms of chronic bronchitis, emphysema, and even asthma. It is not a rescue inhaler for acute symptoms like shortness of breath and wheezing. Its price can vary based on insurance coverage and your purpose for taking it, but some Medicare Part D plans may help pay.\u00a0<\/span><\/p>\n

Does Medicare cover Trelegy?\u00a0<\/span><\/h2>\n

\u201cMany Medicare Part D plans cover Trelegy Ellipta,\u201d says <\/span>Tanya Feke, MD<\/span><\/a>, health policy analyst for <\/span>medicareresources.org<\/span><\/a>. \u201cIn fact, more than 834,000 Medicare beneficiaries used Trelegy in 2022, <\/span>costing Medicare Part D $3.34 billion<\/span><\/a>. This was the eighth most expensive drug expenditure for the program that year. To show how popular the drug has become, Medicare Part D covered half as many beneficiaries, approximately 419,000, in 2020 at a cost of $1.48 billion.\u201d<\/span><\/p>\n

Medicare Part A and Part B plans don\u2019t automatically come with prescription drug coverage. That\u2019s why beneficiaries can add on standalone Part D plans, which help cover drug costs. <\/span>Medicare Advantage (Part C) plans<\/span><\/a>\u2014which include Parts A and B and are offered by private companies that contract with Medicare\u2014usually come pre-bundled with Part D plans, but not always. Plus, not every Medicare prescription drug plan covers Trelegy. To know for sure, check your health plan\u2019s formulary (drug list).<\/span><\/p>\n

Factors influencing Medicare coverage of Trelegy\u00a0<\/span><\/h2>\n

Until the <\/span>Inflation Reduction Act of 2022<\/span><\/a>, Medicare couldn\u2019t negotiate with pharmaceutical companies for lower prices, according to Dr. Feke. \u201cThat all changes in 2026. Given its increasing expenditures for Medicare, it is not surprising that Trelegy is one of the drugs <\/span>expected to undergo price negotiations<\/span><\/a>,\u201d she says.<\/span><\/p>\n

However, \u201cnot all plans may cover the drug outright. Because Part D plans want to decrease their spending too, they may require prior authorizations or step therapy before they approve the drug for coverage. This can make it more difficult to access the drug.\u201d Step therapy is when the plan requires patients to try other, often less expensive, drugs before moving up to a more expensive one.<\/span><\/p>\n

How much does Trelegy cost?<\/span><\/h2>\n

Medicare and insurance are reliable ways to reduce the cost of Trelegy, but some people don\u2019t have access. Without outside assistance from insurance, discounts, or other sources, Trelegy costs an average of <\/span>an average of $918 per 30-day supply<\/a>.<\/span><\/p>\n

Yet that\u2019s just an average, not a set price. Each pharmacy sets its own prices for drugs, so different locations have different prices, even in the same town. \u201cIt depends on other expenses like employee salaries, benefits, and other expenditures like rent, utilities, and more,\u201d says <\/span>Ben Gibson, Pharm.D.<\/span><\/a>, a pharmacist, speaker, and medical writer. \u201cPharmacies have third-party supplies who deliver medication, and they have their own set of expenses.\u201d<\/span><\/p>\n

Regardless of the starting price, discount cards, patient assistance programs, and other financial support can knock down the price of Trelegy at checkout.<\/span><\/p>\n

Cost of Trelegy inhaler with Medicare<\/span><\/h3>\n

Even people who have Medicare coverage might see fluctuation in Trelegy prices. <\/span>The drug\u2019s manufacturer, GSK<\/span><\/a>, says that since the<\/span> cycle of coverage changes throughout the calendar year, Medicare beneficiaries may go through anywhere from one to four phases of coverage\u2014each with a different out-of-pocket cost. Ultimately, the price you pay for your prescription may change throughout the year.<\/span><\/p>\n

Most Medicare and insurance plans have cost-sharing policies, where the beneficiaries are responsible for copays, coinsurance, and more. The specific out-of-pocket costs vary between plans, but the patient often has to pay <\/span>something<\/span><\/i>\u2014even if it\u2019s small.<\/span><\/p>\n

GSK claims that 82% of people with Medicare prescription drug coverage for Trelegy pay less than $50 per month, and the remaining 18% pay around $159 per month.<\/span><\/p>\n

Beneficiaries who qualify for <\/span>Medicare Extra Help<\/span><\/a> may be able to get Trelegy Ellipta for even less, with no deductible or plan premiums.\u00a0<\/span><\/p>\n

Savings options if Medicare doesn’t cover Trelegy<\/span><\/h2>\n

If your insurance company or Medicare prescription plan doesn\u2019t cover Trelegy, there are still several <\/span>effective ways to cut costs<\/span><\/a>. Here are a few of the most reliable.\u00a0<\/span><\/p>\n

Enroll in the GSK patient assistance program<\/span><\/h3>\n

Drug manufacturers are well aware of the prices their prescription medications command, and some have made efforts to help patients afford them, including GSK. With <\/span>GSK for You<\/span><\/a>, anyone based in the United States who has Medicare or no insurance at all\u2014and meets other financial requirements\u2014might get Trelegy at no cost. To qualify, patients must not be co-enrolled in any assistance programs from the government, nonprofits, or other third parties.<\/span><\/p>\n

Eligible patients can enroll by mail, fax, or phone, and if accepted, they must re-enroll every 12 months.\u00a0<\/span><\/p>\n

RELATED: <\/b>Trelegy Ellipta patient assistance program: Eligibility & more<\/b><\/a><\/p>\n

Sign up for the Trelegy savings program<\/span><\/h3>\n

As we mentioned, insurance coverage doesn\u2019t necessarily mean free or low-cost Trelegy. Some plans will only cover a small portion of the drug\u2019s total cost. For these people, Trelegy has <\/span>a savings program<\/span><\/a> that may cover the rest.<\/span><\/p>\n

Uninsured patients are eligible for this program, as are patients with private health insurance plans that cover some (but not all) of their Trelegy price,with maximum savings up to the Wholesale Acquisition Cost (WAC) minus $35 per month, meaning you pay $35 or less. Either way, the eligibility requirements say enrollees must not receive assistance from Medicare, Medicaid, or other government programs.<\/span><\/p>\n

Use other Trelegy coupons<\/span><\/h3>\n

SingleCare has coupons for thousands of drugs, including Trelegy, and they\u2019re redeemable at over 35,000 pharmacies nationwide. By <\/span>signing up for a free SingleCare card<\/span><\/a>, you could get Trelegy for around $534instead of the $918 average. You can\u2019t use SingleCare\u2019s <\/span>Trelegy coupons<\/span><\/a> simultaneously with insurance or Medicare coverage, but they\u2019re a good option for people whose plans don\u2019t cover Trelegy.<\/span><\/p>\n

Consider two-inhaler treatment<\/span><\/h3>\n

Each Trelegy inhaler contains three different drugs: fluticasone furoate, umeclidinium, and vilanterol. Administering all three at once is convenient, but some people use two separate inhalers instead, which may come at a lower cost. There are a couple of studies that demonstrated that three-in-one treatment is slightly<\/span> more effective<\/span><\/a> and<\/span> affordable<\/span><\/a>, but that\u2019s not the case for everyone.<\/span><\/p>\n

\u201cThis is not a starter medicine. People using a medication with this many active ingredients tend to have more serious lung disease. Your healthcare provider should evaluate your condition and make sure that you require this level of medication,\u201d Dr. Feke says. \u201cIf so, and if you have reasonable drug coverage, it may be worth it to go for Trelegy. If not, using two or more medications to cover the recommended drugs may be a good option.\u201d So, ask your healthcare provider for additional information on whether two-inhaler treatment\u2014or<\/span> Trelegy alternatives<\/span><\/a>\u2014might be a viable option.<\/span><\/p>\n

Locate cheaper pharmacy options<\/span><\/h3>\n

Pharmacies are like any other store\u2014they determine their own prices. And those prices can vary quite a bit. Calling around to several different pharmacies could help you find the best price on Trelegy in your area.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

For nearly 4.6% of adults in the United States, the coughing, wheezing, and difficulty breathing of chronic obstructive pulmonary disease (COPD) is a daily battle. Fortunately, drugs like Trelegy Ellipta can help. Trelegy is a combination inhaler that contains three ingredients to prevent and control the symptoms of chronic bronchitis, emphysema, and even asthma. It […]<\/p>\n","protected":false},"author":15,"featured_media":628537,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[15],"coauthors":[8861],"class_list":["post-628536","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-medicare","wpautop"],"acf":[],"yoast_head":"\nDoes Medicare cover Trelegy Ellipta?<\/title>\n<meta name=\"description\" content=\"Most Medicare Part D plans cover Trelegy Ellipta, but it ultimately depends on the details of the prescription drug plan.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-trelegy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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