Medicare Part D coverage · rivaroxaban · RxCUI 2588066
rivaroxaban 1 MG/ML Oral Suspension [Xarelto]
Per the CMS 2026 Part D formulary file, rivaroxaban 1 MG/ML Oral Suspension [Xarelto] is covered by 3,315 Medicare Part D plans (65.6% of enrollable products), averaging Tier 2.6, with prior authorization required on 0% of covering formularies.
- 65.6%
- Plan coverage
- 3,315
- Plans covering
- T2.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for rivaroxaban 1 MG/ML Oral Suspension [Xarelto]
Per the CMS 2026 Part D formulary file, rivaroxaban 1 MG/ML Oral Suspension [Xarelto] (RxNorm concept RXCUI 2588066, generic name rivaroxaban) appears on 181 distinct formulary files spanning 3,315 Medicare Part D plan offerings - 65.6% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.6.
Real-world access to rivaroxaban 1 MG/ML Oral Suspension [Xarelto] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 3.9% require step therapy. 93.9% 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 [Xarelto] 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 [Xarelto] today.
Coverage Details
- Formularies covering
- 181
- Plans covering
- 3,315
- Coverage rate
- 65.6%
- Tier range
- Tier 1 – Tier 3
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 3.9% of formularies
- Quantity limits
- 93.9% 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 [Xarelto]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| 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 |
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
Show the next 30 plans
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | No | $10.50 | OR, WA |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $12.00 | CA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | No | $14.70 | NC |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is rivaroxaban 1 MG/ML Oral Suspension [Xarelto] covered by Medicare Part D?
Yes, rivaroxaban 1 MG/ML Oral Suspension [Xarelto] is covered by 3,315 Medicare Part D plans (65.6% of all Part D formularies).
What tier is rivaroxaban 1 MG/ML Oral Suspension [Xarelto] on Medicare Part D plans?
rivaroxaban 1 MG/ML Oral Suspension [Xarelto] averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 3.
Does rivaroxaban 1 MG/ML Oral Suspension [Xarelto] require prior authorization?
0% of Part D formularies require prior authorization for rivaroxaban 1 MG/ML Oral Suspension [Xarelto]. Step therapy: 3.9%. Quantity limits: 93.9%.
How much does Medicare spend on rivaroxaban 1 MG/ML Oral Suspension [Xarelto]?
In 2023, total Medicare Part D spending on rivaroxaban 1 MG/ML Oral Suspension [Xarelto] 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
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA