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

Xarelto is covered on most commercial, Medicare, and Medicaid formularies
Some plans prefer Eliquis over Xarelto, placing Xarelto on a higher (more expensive) tier
Janssen's savings card reduces cost to $10/month for eligible commercially insured patients
Without insurance, Xarelto costs approximately $550 to $600 per month
Medicare Part D covers Xarelto with the $2,000 annual out-of-pocket cap applying
Generic rivaroxaban may become available in the 2027 to 2029 timeframe based on patent expirations

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Frequently Asked Questions

Is Xarelto or Eliquis cheaper with insurance?

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.

Is there a generic for Xarelto?

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.

Does Xarelto have a patient assistance program?

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.

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