Medicare Part D coverage · rivaroxaban · RxCUI 2588062
rivaroxaban 1 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, rivaroxaban 1 MG/ML Oral Suspension is covered by 3,673 Medicare Part D plans (72.7% of enrollable products), averaging Tier 2.3, with prior authorization required on 0.4% of covering formularies.
- 72.7%
- Plan coverage
- 3,673
- Plans covering
- T2.3
- Avg tier
- 0.4%
- Prior auth required
What the CMS Formulary Data Shows for rivaroxaban 1 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, rivaroxaban 1 MG/ML Oral Suspension (RxNorm concept RXCUI 2588062, generic name rivaroxaban) appears on 264 distinct formulary files spanning 3,673 Medicare Part D plan offerings - 72.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 2.3.
Real-world access to rivaroxaban 1 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0.4% of covering formularies require prior authorization. 2.7% require step therapy. 89% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,324,165 Part D beneficiaries filled rivaroxaban 1 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $6,309,246,823 and an average per-beneficiary annual cost of $4,764.70. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry rivaroxaban 1 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 264
- Plans covering
- 3,673
- Coverage rate
- 72.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0.4% of formularies
- Step therapy required
- 2.7% of formularies
- Quantity limits
- 89% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,324,165
- Total spending
- $6,309,246,823
- Avg per beneficiary
- $4,764.70
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering rivaroxaban 1 MG/ML Oral Suspension
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
Show the next 30 plans
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is rivaroxaban 1 MG/ML Oral Suspension covered by Medicare Part D?
Yes, rivaroxaban 1 MG/ML Oral Suspension is covered by 3,673 Medicare Part D plans (72.7% of all Part D formularies).
What tier is rivaroxaban 1 MG/ML Oral Suspension on Medicare Part D plans?
rivaroxaban 1 MG/ML Oral Suspension averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does rivaroxaban 1 MG/ML Oral Suspension require prior authorization?
0.4% of Part D formularies require prior authorization for rivaroxaban 1 MG/ML Oral Suspension. Step therapy: 2.7%. Quantity limits: 89%.
How much does Medicare spend on rivaroxaban 1 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on rivaroxaban 1 MG/ML Oral Suspension was $6,309,246,823, covering 1,324,165 beneficiaries. The average spend per beneficiary was $4,764.70.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
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