DELAWARE MEDICARE PART D DRUG COVERAGE. PLEASE BE AWARE OF THIS CHANGE OR IT COULD COST YOU DEARLY. YOU MUST READ YOUR DRUG PART D PLAN.
Family member on Medicare and I handle all paper work for them. They are on XARALTO and currently have Wellcare and it is a covered drug at the now “old” 2026 Medicare rate that was previously negotiated to be between $150- $197 per RX after deductible.
Xaralto a common anticoagulant for is NOT covered for 2027 resulting in a cost, over 7 different plans of $8,100 - $11,00. You will need to satisfy the $700 deductible first for any plan D, then the cost of the drug. Once you reach $2400 the cost of all drugs are “free” for the remainder of the year.
I am researching this and the doctor's office told me to research Trump RX which the cost is $591 per quarter. They are not through insurance and that is the charge through 2027.
The other end around is to contact your Part D provider and ask to be placed on the Prescription Payment Plan and they will charge you monthly for all the drugs you get. You will not pay at the mail order or pharmacy. So what this will do, in our case is $2200 for Xaralto plus the $700 part D deductible and they will bill us. The “bonus, “ if you will, is that you get your drugs upfront but have a payment plan for them for the full year.
Long story short the great negotiated prices on Xaralto for 2026, will be worthless in 2027 because none of the plans available in De have Xaralto as a covered drug. I read everything and therefore I discovered this prior to the Open Enrollment on 10/15. The really egregious part of this is that many seniors just keep their plans from year to year and I am afraid they are going to be in for sticker shock in January since Xaralto is no longer covered. Many don’t have advocates to read things like this and this could create financial difficulties for them. Please check your plans and those of your loved ones.