Specialty Drug


PEMBROLIZUMAB (pem broe liz ue mab) is a monoclonal antibody. It is used to treat melanoma, head and neck cancer, Hodgkin lymphoma, and non-small cell lung cancer. Compare PD inhibitors.

Pembrolizumab Medicare Coverage


Does Medicare cover Keytruda?

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

How much is my Keytruda 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
$2156 – $2406
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
$539 – $794
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$970 – $1083
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
$15 – $120
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 Pembrolizumab

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

Patient Assistance Program
Receive your prescription at no charge if you are eligible.
Patient Assistance Program
Save at least $5 per month on your prescription.
Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.

Find Your Pembrolizumab 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 4 vials of Keytruda 50mg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $619
AARP MedicareComplete Plan 1 (HMO) $648
AARP MedicareComplete SecureHorizons (HMO) $599
AARP MedicareRx Preferred (PDP) $722
AARP MedicareRx Saver Plus (PDP) $564
Aetna Medicare Rx Saver (PDP) $573
Cigna-HealthSpring Preferred (HMO) $701
Cigna-HealthSpring Rx Secure (PDP) $557
Cigna-HealthSpring Rx Secure-Extra (PDP) $602
EnvisionRxPlus Silver (PDP) $553
Express Scripts Medicare - Value (PDP) $569
First Health Part D Value Plus (PDP) $756
Humana Enhanced (PDP) $739
Humana Preferred Rx Plan (PDP) $560
Humana Walmart Rx Plan (PDP) $560
Kaiser Permanente Senior Advantage (HMO) $758
MedicareBlue Rx Standard (PDP) $597
SilverScript Choice (PDP) $780
Symphonix Value Rx (PDP) $565
WellCare Classic (PDP) $594
Don't see your Medicare plan above?

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Pembrolizumab Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Keytruda 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 Keytruda typically on?

Tier 5

Medicare plans typically list Keytruda 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). If you encounter any issues, please let us know.
GoodRx is not sponsored by or affiliated with any of the pharmacies identified in its price comparisons. All trademarks, brands, logos and copyright images are property of their respective owners and rights holders and are used solely to represent the products of these rights holders. This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. GoodRx is not offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. GoodRx provides no warranty for any of the pricing data or other information. Please seek medical advice before starting, changing or terminating any medical treatment.