Specialty Drug


BELIMUMAB is a medicine used to treat active systemic lupus erythematosus (SLE). This medicine is used with standard therapy for SLE. It is not a cure. Compare BLyS-specific inhibitors.

Benlysta Medicare Coverage


Does Medicare cover Benlysta?

99% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Benlysta 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
$477 – $532
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
$119 – $519
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$174 – $242
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
$24 – $27
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 Benlysta

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

Patient Assistance Program
Save at least $5 per month on your prescription.

Find Your Benlysta 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 6 vials of Benlysta 120mg

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $206
AARP MedicareRx Saver Plus (PDP) $130
AARP MedicareRx Walgreens (PDP) $128
Aetna Medicare Rx Saver (PDP) $127
Anthem Blue Cross MedicareRx Plus (PDP) $161
Anthem MediBlue Essential (HMO) $152
CareMore Value Plus (HMO) $282
Cigna-HealthSpring Preferred (HMO) $146
EnvisionRxPlus (PDP) $128
Express Scripts Medicare - Choice (PDP) $130
Express Scripts Medicare - Value (PDP) $125
First Health Part D Value Plus (PDP) $168
Humana Enhanced (PDP) $160
Humana Preferred Rx Plan (PDP) $121
Humana Walmart Rx Plan (PDP) $121
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $176
MedicareBlue Rx Standard (PDP) $125
SilverScript Plus (PDP) $170
Symphonix Value Rx (PDP) $130
TexanPlus Classic (HMO) $414
Don't see your Medicare plan above?

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

Benlysta Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

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

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 doctor 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 Benlysta typically on?

Tier 5

Medicare plans typically list Benlysta 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 January 2017 and the information may be updated. If you encounter any issues, please let us know.
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