Key takeaways:
Paxlovid (nirmatrelvir / ritonavir) is a medication that can treat mild-to-moderate COVID-19. Without insurance, the average cost of Paxlovid is $1793.72.
If you have commercial insurance, you may be able to get Paxlovid for as little as $0 with a manufacturer copay card.
If you are uninsured or have government-based insurance, you may be eligible for Paxlovid’s patient assistance program. People who meet certain financial requirements may be able to get Paxlovid for free.
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If you have mild-to-moderate COVID-19, your healthcare team may prescribe you Paxlovid (nirmatrelvir / ritonavir). This 5-day course of antiviral tablets can help lower the risk of hospitalizations and death for people who have a high risk of developing severe COVID. It can be especially beneficial for older adults and people with certain health conditions.
You’ll want to get started with Paxlovid as soon as possible. But for many people, cost is top of mind when purchasing medications. And with an average retail cost over $1,600, Paxlovid without insurance could seem out of reach. But there are plenty of ways to lower your costs — and maybe even get Paxlovid for free.
How much does Paxlovid cost without insurance?
Without insurance or discounts, the standard Paxlovid dose pack costs an average of $1793.72. This version of Paxlovid contains 30 tablets.
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If you have kidney issues, you may need a lower Paxlovid dosage. This version of the medication contains only 20 tablets in the package. The average retail cost for this form of Paxlovid is $1746.14.
Which factors affect the cost of Paxlovid?
Several factors that determine how much you’ll pay for Paxlovid, including:
Location: Medications have different prices depending on where you live. For instance, prescription costs tend to be lower in Denver compared with New Orleans.
Pharmacy: Each pharmacy may charge different amounts for prescriptions — even in the same neighborhood. So it may pay to shop around for the best price.
Fill quantity: There may be a difference in cost if you’re filling the standard Paxlovid dose pack or the reduced-dose pack. These two versions contain different numbers of pills.
Insurance: If you have insurance and it covers Paxlovid, this will likely reduce the cost a lot. Most insurance plans cover this medication.
Discounts: Your cost will also be lower if you’re applying manufacturer copay cards to your Paxlovid prescription.
Does insurance cover Paxlovid?
Most insurance plans, including Medicare and Medicaid, cover Paxlovid. Insurance plans purchased through the Affordable Care Act (ACA) marketplace are more likely than other insurance providers to require a prior authorization. It’s very rare for any insurance provider to require you to complete step therapy (trying other medications first).
It’s a good idea to review your plan’s summary of benefits and coverage and formulary (list of covered medications). This can help you determine if your plan covers Paxlovid. If you’re unsure, you can also call the members’ service number on your prescription insurance card.
How different insurance plans cover Paxlovid
This table shows the likelihood of coverage for the standard dose pack of Paxlovid for different insurance providers. It also shows whether plans typically require prior authorization or step therapy.
Insurance type | Enrollees covered for Paxlovid | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
96.8% | 21.2% | 0.3% | |
Commercial plans (excluding ACA plans) | 98.3% | 1% | 0% |
Medicare (Medicare Advantage and Part D plans) | 100% | 0% | 0% |
Medicaid, including state-run and managed care plans | 99.8% | 3.7% | 0.4% |
Source: Managed Markets Insight & Technology, LLC™, as of September 11, 2025. (See methodology below.)
Tips if Paxlovid isn’t covered by insurance
If your insurance doesn’t cover Paxlovid, try these options:
See if you qualify to receive Paxlovid through the U.S. Government Patient Assistance Program (USG PAP; details below).
Contact your prescriber to discuss alternatives. Your insurance provider may offer better coverage for Paxlovid alternatives such as Veklury (remdesivir) or Lagevrio (molnupiravir).
Ways to save on prescription medications: From using a GoodRx coupon to making the most of your health savings account, here are some ways to save on prescription medications.
Typical doses: Pharmacists discuss doses of Paxlovid (nirmatrelvir / ritonavir) for people with and without kidney problems.
Getting started: Find out how to get Paxlovid fast, so you can start feeling better sooner.
Ways to save on Paxlovid
There are several ways to save on Paxlovid, with and without insurance. Below are three savings tips to consider.
1. See if you qualify for the Paxcess Co-Pay Savings Program
If you have commercial insurance, you may be eligible for Paxlovid’s manufacturer copay card. If you qualify, you may pay as little as $0 for Paxlovid. The card provides a maximum annual savings of $1,500. You can sign up online.
To qualify for the Paxcess Co-Pay Savings Program, you must:
Have commercial insurance that covers part of your Paxlovid prescription
Not be covered by a state or federally funded insurance program, such as Medicare, Medicaid, or Tricare
Be at least 12 years old
Live in the U.S. or Puerto Rico
Must not have used the copay card within the past 30 days
Only certain pharmacies can process Paxlovid’s copay card. If your pharmacy doesn’t participate in the program, you can fill out a rebate form. Paxlovid’s manufacturer (Pfizer) will then reimburse your out-of-pocket costs if you meet the eligibility criteria listed above.
Along with the completed rebate form, you’ll also need to provide a copy of your pharmacy medication receipt (not the cash register receipt). This document is also called the pharmacy label. It must have the following information listed on it:
Your name and address
The pharmacy’s name, address, and phone number
Your prescriber’s name, address, and phone number
Your prescription number
The National Drug Code (NDC) for the medication
The medication name, dose, and fill quantity
The date the prescription was filled
The rebate will be mailed to you about 6 to 8 weeks after your form is received and processed.
2. Check if you’re eligible for Paxlovid’s patient assistance program
You may be able to get Paxlovid for free through the USG PAP. This program offers the medication at no cost to people who meet certain financial requirements.
You can sign up for Paxlovid’s patient assistance program online or by calling 1-877-219-7225. If you qualify, you can fill your prescription at a pharmacy or have it shipped to you by overnight mail.
To qualify for the USG PAP, you must:
Be uninsured or have insurance through Medicare, Medicaid, Tricare, or the Veterans Affairs Community Care Network
Not have commercial insurance
Be at least 12 years old
Live in the U.S. or a U.S. territory
Be prescribed Paxlovid by a healthcare professional licensed in the U.S. or a U.S. territory
Show proof of income
3. Tap into your HSA, FSA, or HRA
Consider paying for your prescription with a health savings account (HSA), a flexible spending account (FSA), or a health reimbursement arrangement (HRA) if you have one. These let you use pretax dollars to pay for qualifying medical expenses, such as prescription copays. They can help you save money through tax savings.
You have to use FSA funds before their expiration date. But HSA funds typically roll over. HRA funds may or may not expire, depending on your plan.
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The bottom line
Paxlovid (nirmatrelvir / ritonavir) is an oral antiviral that can treat mild-to-moderate COVID-19. Without insurance, the standard Paxlovid dose pack may cost about $1793.72. Most insurance plans cover this COVID treatment. But plans purchased through the Affordable Care Act marketplace are more likely than others to require a prior authorization.
There are ways to save on Paxlovid. If you have commercial insurance, a manufacturer copay card may lower your prescription cost to $0. Those without insurance or with government-based insurance may qualify to receive Paxlovid for free through the U.S. Government Patient Assistance Program.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of September 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Medicaid.gov. (n.d.). Managed care. U.S. Centers for Medicare & Medicaid Services.
Paxcess. (n.d.). Understanding coverage options. Pfizer.
Pfizer. (n.d.). Enroll in the Co-Pay Savings Program.
Pfizer. (n.d.). Paxcess Co-pay Savings Program terms & conditions.
Pfizer. (n.d.). US Government Patient Assistance Program, operated by Pfizer—terms and conditions.
U.S. Food and Drug Administration. (2024). National drug code directory.
