Specialty Drug


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Apokyn Medicare Coverage


Does Medicare cover Apokyn?

100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Apokyn co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Donut Hole
Post-Donut Hole
Co-Pay Range
$1499 – $5480
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$1241 – $5469
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$2234 – $2630
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$248 – $278
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Apokyn

Here are some ways that may lower the cost of your Apokyn prescription.

Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.

Find Your Apokyn Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 27 cartridges (3ml) of Apokyn 30mg/3ml

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $2128
AARP MedicareRx Saver Plus (PDP) $1339
AARP MedicareRx Walgreens (PDP) $1314
Aetna Medicare Rx Saver (PDP) $1414
Anthem Blue Cross MedicareRx Plus (PDP) $1692
Anthem MediBlue Essential (HMO) $1613
Cigna-HealthSpring Preferred (HMO) $1530
EnvisionRxPlus (PDP) $1318
Express Scripts Medicare - Choice (PDP) $1328
Express Scripts Medicare - Value (PDP) $1277
First Health Part D Value Plus (PDP) $1769
Humana Enhanced (PDP) $1649
Humana Preferred Rx Plan (PDP) $1249
Humana Walmart Rx Plan (PDP) $1249
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $1499
MedicareBlue Rx Standard (PDP) $1368
SilverScript Plus (PDP) $1765
Symphonix Value Rx (PDP) $1339
TexanPlus Classic (HMO) $4518
WellCare Classic (PDP) $1361
Don't see your Medicare plan above?

Find and configure your plan to see exact co-pay prices for your meds.

Apokyn Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Apokyn that may include:

Quantity Limits

Most Medicare plans restrict the amount of this prescription that can be purchased at one time. If you need to purchase a greater amount at one time, it may not be covered. Your options are to wait until that time period has passed before refilling, call your plan and ask for an exception, or consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your health care provider fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Apokyn typically on?

Tier 5

Medicare plans typically list Apokyn in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). They are accurate as-of July 2018 and the information may be updated. If you encounter any issues, please let us know.
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In all states except Tennessee, GoodRx is considered a marketer of prescription discount cards, and is not required to register as a discount card provider. In Tennessee, GoodRx is registered as a Prescription Drug Discount Plan Operator.
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