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johngraham55
Contributor ⭐
October 5, 2026
Question

2027 Medicare coverage of Xarelto

  • October 5, 2026
  • 3 replies
  • 56 views

Can you explain what is happening to Xarelto coverage in 2027 Medicare? 

It seems that in my zip code =12589, Ulster County, only CVS is providing coverage for 20 mg.

    3 replies

    TRL1111
    Community Champion ⭐
    October 7, 2026

    BTW your suggestion needs additional discussion:

     

    I think a better course of action would be for you to consult a different chatbot.  I can’t find anywehre that says Xarelto is “carefully engineered as a single, extended-release tablet.”  And in fact, the NIH and Xarelto’s website say if someone can’t swallow the tablet, they can crush it.

    TRL1111
    Community Champion ⭐
    October 5, 2026

    I’m not sure what you mean by CVS providing coverage--it’s a pharmacy and not a prescription drug plan.

    There’s something going on with name-brand Xarelto that I haven’t been following.  But one solution is to take the generic, which is free on Wellcare’s Value Script plan.  The only rub is you have to take 8 a day.  But hey, it’s free.

    There’s someone on Reddit who has Wellcare and his prescription for 8 per day is covered.  It cost less than $10 in 2026, and will be $0 in 2027. 

    People warn about quantity limits, but Wellcare’s formulary doesn’t have a quantity limit for generic Xarelto..

    johngraham55Author
    Contributor ⭐
    October 5, 2026

    Aetna Medicare SilverScript Choice (PDP) provides the coverage

    Aetna Medicare - SilverScript (PDP) uses CVS.

    BTW your suggestion needs additional discussion:

    Why You Should Not Substitute Low-Dose Tablets

    • Inaccurate Release Timing: Brand-name Xarelto 20mg is carefully engineered as a single, extended-release tablet designed to safely thin your blood over a full 24-hour period. Taking eight 2.5mg tablets at once changes how the drug dissolves and absorbs into your system.
    • Severe Bleeding Risk: Swallowing eight tablets at once can cause a sudden, dangerous spike of the medication in your bloodstream. This significantly increases your risk of severe, life-threatening internal bleeding.
    • Rapid Loss of Protection: Because the 2.5mg generic formulation is metabolized differently than the 20mg pill, the medication may leave your system too quickly. This can leave you completely unprotected against blood clots and strokes later in the day.
    • Insurance Denial:
    Terms & ConditionsAccessibility statement