Does Medicare cover PCSK9 inhibitors like Repatha and Praluent?
Answered by 4 licensed agents
These medications are usually covered under Part D, and the insurance company may require prior authorization or other criteria before approving them. Coverage and out-of-pocket costs can vary considerably from one plan to another.
If you’re already taking Repatha or Praluent, or your doctor is considering prescribing one, I would recommend checking your specific plan’s formulary and coverage requirements before assuming it’s covered.
This is also why it’s so important to include all of your medications when comparing Medicare plans each year. The plan with the lowest monthly premium isn’t necessarily the plan that will cost you the least overall.
Answered by Cody Biggs on August 20, 2026
Broker Licensed in LA, AL, AZ & 24 other states
Answered by Kenneth Parsons on August 20, 2026
Agent Licensed in NM, AZ & TX
Answered by Michelle Hylton on August 21, 2026
Broker Licensed in AL, CA, FL & 5 other states
Answered by Marcia West on August 18, 2026
Agent Licensed in WA, FL, GA, MI, TX & VA
Tags: Coverage Medicare Part D Prescription Drug
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