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Tagrisso Medicare Coverage

Overview

Does Medicare cover Tagrisso?

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

How much is my Tagrisso 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
$15542
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
$3886 – $5129
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$6994
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 – $777
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 Tagrisso

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

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

Find Your Tagrisso 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 30 tablets of Tagrisso 80mg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $4238
AARP MedicareComplete Plan 1 (HMO) $4449
AARP MedicareComplete SecureHorizons (HMO) $4105
AARP MedicareRx Preferred (PDP) $4970
AARP MedicareRx Saver Plus (PDP) $3886
Aetna Medicare Rx Saver (PDP) $3886
Cigna-HealthSpring Preferred (HMO) $4767
Cigna-HealthSpring Rx Secure (PDP) $3886
Cigna-HealthSpring Rx Secure-Extra (PDP) $4196
EnvisionRxPlus Silver (PDP) $3886
Express Scripts Medicare - Value (PDP) $3886
First Health Part D Value Plus (PDP) $5129
Humana Enhanced (PDP) $5129
Humana Preferred Rx Plan (PDP) $3886
Humana Walmart Rx Plan (PDP) $3886
Kaiser Permanente Senior Advantage (HMO) $5129
MedicareBlue Rx Standard (PDP) $3886
SilverScript Choice (PDP) $5092
Symphonix Value Rx (PDP) $3886
WellCare Classic (PDP) $3886
Don't see your Medicare plan above?

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Tagrisso Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

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

Tier 5

Medicare plans typically list Tagrisso 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.
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