Riociguat
Specialty Drug

Adempas

RIOCIGUAT is used to treat pulmonary hypertension. This medicine may help make exercise and breathing easier. Compare sGC stimulators.

Availability: Adempas is only available at certified specialty pharmacies. Learn More

Riociguat Medicare Coverage

Overview

Does Medicare cover Adempas?

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

How much is my Adempas co-pay with Medicare?

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

Deductible
Typical
Donut Hole
Post-Donut Hole
Co-Pay Range
$8903 – $9975
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
$2226 – $9835
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$3203 – $13332
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
$445 – $1481
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 Riociguat

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

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

Find Your Riociguat 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 252 tablets of Adempas 0.5mg

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP)Lower price available $3854
AARP MedicareRx Saver Plus (PDP)Lower price available $2430
AARP MedicareRx Walgreens (PDP)Lower price available $2409
Aetna Medicare Rx Saver (PDP)Lower price available $2402
Anthem Blue Cross MedicareRx Plus (PDP)Lower price available $3033
Anthem MediBlue Essential (HMO)Lower price available $2931
CareMore Value Plus (HMO)Lower price available $5318
Cigna-HealthSpring Preferred (HMO)Lower price available $2715
EnvisionRxPlus (PDP)Lower price available $2376
Express Scripts Medicare - Choice (PDP)Lower price available $2442
Express Scripts Medicare - Value (PDP)Lower price available $2348
First Health Part D Value Plus (PDP)Lower price available $3171
Humana Enhanced (PDP)Lower price available $2986
Humana Preferred Rx Plan (PDP)Lower price available $2262
Humana Walmart Rx Plan (PDP)Lower price available $2262
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost)Lower price available $3187
MedicareBlue Rx Standard (PDP)Lower price available $2494
SilverScript Plus (PDP)Lower price available $7951
Symphonix Value Rx (PDP)Lower price available $2430
TexanPlus Classic (HMO)Lower price available $8186
Don't see your Medicare plan above?

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

Riociguat Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

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

Tier 5

Medicare plans typically list Adempas 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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