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Vivitrol Medicare Coverage

Overview

Does Medicare cover Vivitrol?

Maybe.
32% of Medicare Part D and Medicare Advantage plans cover this drug, so it's pretty much a toss-up.

How much is my Vivitrol 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
$1284 – $1505
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
$90 – $1505
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$572 – $1505
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 – $1505
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 Vivitrol

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

Manufacturer Coupon
Save up to $500 per prescription.
Fill a 90-Day Supply to Save
You may be able to lower your total cost by filling a greater quantity at one time.

Find Your Vivitrol 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 1 carton (1 vial) of Vivitrol 380mg/vial

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $363
AARP MedicareComplete Plan 1 (HMO) $380
AARP MedicareComplete SecureHorizons (HMO) $355
AARP MedicareRx Preferred (PDP) $422
AARP MedicareRx Saver Plus (PDP) $329
Aetna Medicare Rx Saver (PDP)Lower price available $1505
Cigna-HealthSpring Preferred (HMO)Lower price available $1492
Cigna-HealthSpring Rx Secure (PDP)Lower price available $1505
Cigna-HealthSpring Rx Secure-Extra (PDP)Lower price available $1505
EnvisionRxPlus Silver (PDP)Lower price available $1505
Express Scripts Medicare - Value (PDP)Lower price available $1505
First Health Part D Value Plus (PDP)Lower price available $1505
Humana Enhanced (PDP) $432
Humana Preferred Rx Plan (PDP)Lower price available $1505
Humana Walmart Rx Plan (PDP)Lower price available $1505
Kaiser Permanente Senior Advantage (HMO) $90
MedicareBlue Rx Standard (PDP)Lower price available $1505
SilverScript Choice (PDP)Lower price available $1505
Symphonix Value Rx (PDP) $329
WellCare Classic (PDP)Lower price available $1505
Don't see your Medicare plan above?

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

Vivitrol Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

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

Tier 5

Medicare plans typically list Vivitrol 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.