{"id":629327,"date":"2024-08-09T11:53:42","date_gmt":"2024-08-09T15:53:42","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=629327"},"modified":"2025-12-12T18:04:12","modified_gmt":"2025-12-12T23:04:12","slug":"rexulti-cost-with-medicare","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/rexulti-cost-with-medicare\/","title":{"rendered":"How much does Rexulti cost with Medicare?"},"content":{"rendered":"

Rexulti<\/span><\/a> (brexpiprazole)is a prescription drug that was approved in 2015 by the Food and Drug Administration (FDA). In addition to <\/span>schizophrenia<\/span><\/a>, it is prescribed to treat <\/span>major depressive disorder<\/span><\/a> when combined with other medications. In 2023, Rexulti was approved for treatment of agitation associated with dementia from <\/span>Alzheimer\u2019s disease<\/span><\/a>. Rexulti is not meant to be used as an \u201cas needed\u201d medication for this condition, however.<\/span><\/p>\n

\u201cRexulti is kind of an add-on drug for residual symptoms in people with major depressive disorder who are already on other medications,\u201d explains <\/span>Jenepher K. Piper<\/span><\/a>, a certified registered nurse practitioner at Mercy Medical Center in Baltimore, Maryland. \u201cInstead of upping the dose of what the person is currently taking, Rexulti could be added and the dose of the first medication kept at the same level. Having lower doses of two drugs rather than a higher dose of one drug gives better results.\u201d<\/span><\/p>\n

Without insurance, Rexulti costs over $2,052 per month. But with Medicare, the average Part D beneficiary pays about $21 per month. Here\u2019s everything you need to know about how much you can expect to pay for Rexulti with Medicare.<\/span><\/p>\n\t\t

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Save up to 80% on Rexulti with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tRexulti 1 mg (30 Tablets)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t
\n\t\t\t\"Kroger\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$1471.43\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
\n\t\t\t
\n\t\t\t\"Harris\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$1471.43\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Rexulti prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t\n

How Medicare covers prescription drugs<\/span><\/h2>\n

When you have original Medicare, which includes <\/span>Medicare Part A<\/span><\/a> (for inpatient hospital care) and <\/span>Medicare Part B<\/span><\/a> (for healthcare provider services, outpatient care, and medical supplies), you have some choices when it comes to prescription drug coverage.<\/span><\/p>\n

One option is to purchase a stand-alone <\/span>Medicare Part D plan<\/span><\/a>. Each insurance plan has a list of covered drugs known as a formulary, with drugs assigned certain levels, called \u201ctiers.\u201d Drugs in the lower tiers generally cost less than drugs in higher tiers. Formularies can change what tier they assign a particular drug at any time. If you already take certain drugs, you should compare the formularies of several plans so that you can choose the best plan for you.<\/span><\/p>\n

Another option instead of enrolling in a stand-alone Part D plan is to enroll in a <\/span>Medicare Advantage plan<\/span><\/a>\u2014a way of receiving your inpatient and outpatient Medicare benefits through private companies. These companies must follow rules set by Medicare. In addition to medical and prescription drug coverage, these plans may include preventive dental, vision, and hearing benefits. When you have a Medicare Advantage plan, your prescription drug plan is typically built in.\u00a0<\/span><\/p>\n

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

If you have Medicare drug coverage either through Medicare Advantage or Part D, the cost of your Rexulti prescription may be partially covered. But Medicare will not cover Rexulti if it is prescribed for Alzheimer\u2019s disease and dementia without agitation. \u201cNor will Medicare cover Rexulti if it is the only medication being prescribed for major depressive disorder,\u201d Piper says.<\/span><\/p>\n

While your Medicare drug coverage may cover part of the cost of Rexulti, you will most likely be responsible for part of the cost. \u201cThere is such a big variation among the various insurance plans and what they charge,\u201d says <\/span>Selly Vazquez<\/span><\/a>, an insurance specialist in Brookfield, Connecticut. When a drug costs thousands of dollars per month, she explains, it typically means that it is in Tier 4 or Tier 5 on the insurance company\u2019s formulary. \u201cThe price really varies from plan to plan.\u201d<\/span><\/p>\n

What is the cost of Rexulti on Medicare?<\/span><\/h2>\n

The <\/span>list price of Rexulti<\/span><\/a> is $1,516 per month, though this is not the cost that most people will actually pay. In fact, the <\/span>average retail price of Rexulti<\/span><\/a> is over $2,052 for a 30-day supply. According to Otsuka America Pharmaceutical, Inc., which manufactures Rexulti, your out-of-pocket costs for Rexulti with Medicare could be around $21 per month. However, this varies by plan and what <\/span>coverage stage<\/span><\/a> you are in, among other factors.<\/span><\/p>\n

One issue with getting Rexulti paid for by Medicare is that a person\u2019s insurance company may require <\/span>step therapy<\/span><\/a> and <\/span>prior approval<\/span><\/a>. \u201cThe company wants the patient to fail on other drugs that are cheaper before they will approve Rexulti,\u201d Piper says.<\/span><\/p>\n

How the prescription drug law affects Rexulti<\/span><\/h2>\n

Under a <\/span>prescription drug law<\/span><\/a> that went into effect on Jan. 1, 2023, people with Medicare Part D drug coverage don\u2019t have to pay copays or coinsurance if their drug costs are high enough to reach the catastrophic coverage phase. And in 2026, annual Part D out-of-pocket costs will be capped at $2,100. For the first time, Medicare will negotiate directly with the manufacturers over the price of certain brand-name drugs.\u00a0<\/span><\/p>\n

How to save on Rexulti<\/span><\/h2>\n

There are a few ways to make Rexulti more affordable:<\/span><\/p>\n