{"id":629182,"date":"2024-08-01T14:48:25","date_gmt":"2024-08-01T18:48:25","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=629182"},"modified":"2026-01-02T17:42:17","modified_gmt":"2026-01-02T22:42:17","slug":"does-medicare-cover-aimovig","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-aimovig\/","title":{"rendered":"Does Medicare cover Aimovig?"},"content":{"rendered":"

Anyone who gets migraine attacks knows they can be debilitating. The throbbing, nausea, distorted vision, and sensitivity to light can render a person couch-bound and pleading for relief. For some, <\/span>Aimovig<\/span><\/a> (erenumab-aooe) can be a big help. This brand-name once-monthly injectable biologic medication targets a migraine catalyst called <\/span>calcitonin gene-related peptide (CGRP)<\/span> to help prevent future attacks. Aimovig\u2019s price depends on where you get it and, most importantly, insurance or Medicare coverage. Medicare often covers it, but that depends on the specific plan.\u00a0<\/span><\/p>\n

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

For anyone paying completely out of pocket, without insurance coverage or help from Medicare, Aimovig costs an average of $1,027 per 140 mg\/mL autoinjector. It\u2019s a once-monthly injection, so that means a year\u2019s worth of Aimovig treatment would cost over $12,000. There are no <\/span>biosimilar alternatives<\/a>, <\/span>which are often less expensive. \u201cWith a patent that will not expire until 2031 at the earliest (patent extensions are common), the cost is unlikely to decrease anytime soon,\u201d says <\/span>Tanya Feke<\/span><\/a>, MD<\/span>, a health policy analyst.<\/span><\/p>\n

Yet that price isn\u2019t set in stone. Insurance coverage and financial assistance programs are available. And retail prices can vary greatly by pharmacy. The <\/span>pharmaceutical supply chain<\/span><\/a> is a complex structure that involves not just pharmacies but manufacturers, wholesalers, pharmacy benefit managers, and insurance companies.<\/span><\/p>\n

While pharmaceutical companies set prices for their drugs, negotiations happen at almost every level, which is why \u201cprices can vary depending on the pharmacy. Some pharmacies may have negotiated better prices with suppliers, leading to lower costs for consumers,\u201d according to <\/span>Ojas Doshi<\/span><\/a>, a product development scientist in the pharmaceutical industry. Sometimes, prices between pharmacies can vary by <\/span>hundreds of dollars<\/span><\/a>.<\/span><\/p>\n

Does Medicare cover Aimovig?<\/span><\/h2>\n

In many cases, yes, Medicare will cover Aimovig. But only under certain Part D or Medicare Advantage plans. \u201cSince Aimovig is an injectable drug typically administered at home, it would likely be covered under Part D plans,\u201d Doshi says. Medicare Part D includes standalone prescription drug plans that Medicare beneficiaries can add to their existing Part A or Part B coverage.<\/span><\/p>\n

Original Medicare (Parts A and B) <\/span>doesn\u2019t cover a wide range of outpatient prescription drugs<\/span><\/a>, but \u201cif Aimovig is administered in a doctor’s office rather than at home, it could be covered under Medicare Part B, which handles outpatient services,\u201d Doshi says. \u201cHowever, this is less common for Aimovig, as it is primarily designed for self-administration.\u201d<\/span><\/p>\n

Some Part D or Medicare Advantage plans, however, may need <\/span>prior authorization<\/span><\/a> before issuing coverage, according to Dr. Feke, who adds that insurers may ask for a few things before covering Aimovig due to the high price of the drug, including:<\/span><\/p>\n