Xarelto (rivaroxaban) is a widely prescribed blood thinner covered by most insurance plans for atrial fibrillation, DVT/PE, and other thrombotic conditions. As a brand-name medication without a generic, Xarelto costs can be significant without insurance. Coverage competes with Eliquis, which many plans prefer, creating step therapy requirements for some patients.
Key Facts
Check Your Specific Plan's Formulary
Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerSources and standards behind this page
Drug coverage in the United States is governed by published rules rather than by any one insurer's summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.
- FDA Orange Book publishes the therapeutic-equivalence ratings that decide whether a generic may be substituted for a brand-name drug.
- FDA generic drug facts sets out what "generic equivalent" means and what a manufacturer must prove.
- CMS prescription drug coverage defines the rules a Medicare drug plan formulary must follow and how it may change mid-year.
- Medicare.gov drug coverage (Part D) states what a Part D plan is required to offer a member.
- CMS prescription drug appeals documents the coverage-determination and exception process when a drug is denied.
This page describes how coverage and formularies work. It is not medical advice, and a reader's own plan documents and prescriber decide what applies to them.
Frequently Asked Questions
It depends on your plan's formulary. Many plans prefer Eliquis and place it on a lower tier with a lower copay. However, some plans prefer Xarelto. Check your specific formulary to see which blood thinner is preferred. Your doctor can prescribe whichever one your plan covers at the lowest cost.
As of 2026, there is no generic rivaroxaban available. Patent settlements suggest generic entry could occur around 2027 to 2029. When generics become available, costs should drop significantly. In the meantime, use manufacturer savings programs and check for preferred alternatives on your formulary.
Yes. Janssen offers the Xarelto Savings Program with a copay card for commercially insured patients (as low as $10/month). For uninsured patients, the Janssen CarePath program may provide Xarelto at reduced or no cost. Medicare patients cannot use copay cards but may qualify for Extra Help or state pharmaceutical assistance programs.
Related Resources
- UnitedHealthcare Formulary 2026
- Cigna Formulary 2026
- Medicare Part D Formulary 2026
- Eliquis cash price comparison on RxGrab
- Warfarin cash price comparison on RxGrab
- Pradaxa cash price comparison on RxGrab
- Savaysa cash price comparison on RxGrab
- Lovenox cash price comparison on RxGrab
- Eliquis patient assistance program
- Patient assistance programs
- Patient assistance programs
- Drug interaction checker tool
- Patient assistance program finder
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