Does Medicare Cover Enbrel?

Drug Coverage · Autoimmune & Skin

Enbrel (etanercept) is used for rheumatoid arthritis and psoriasis.

Does Medicare cover Enbrel?

Yes — Part D covers Enbrel for approved autoimmune conditions. Covered for approved uses such as rheumatoid arthritis, psoriatic arthritis, and plaque psoriasis. Self-injected, so it’s a Part D drug.

Which part of Medicare covers it?

Part D. These are self-administered prescriptions, so they fall under your Part D drug plan (or the drug coverage built into a Medicare Advantage plan), not Part B.

Typical formulary tier

Specialty tier (typically Tier 5). Your exact tier — and copay — depend on the plan you choose, which is why matching the formulary to your medications matters.

Prior authorization & plan rules

Prior authorization is standard, and step therapy (trying a preferred biologic first) is common.

If it isn’t covered (or costs too much)

Appeals with clinical notes, plus manufacturer and foundation assistance, can make it affordable.

• Help paying for Enbrel — assistance programs and grants.
• Compare Part D plans that cover Enbrel on a better tier.
• How drug tiers work · Extra Help for lower-income beneficiaries.

Related medications

• Does Medicare cover Humira? — adalimumab
• Does Medicare cover Rinvoq? — upadacitinib

Related Medicare guides

• All drug coverage · Part D plans · how drug tiers work.
• Medicare costs · Glossary · Medicare Help Center.

Get a Real Answer for Your Plan — Free

Coverage and cost depend on your specific plan and diagnosis. Call us free at 435-219-5120 (TTY: 711) with your medication list, and we’ll tell you exactly what Enbrel costs on your plan — and whether a different plan would cover it better. No cost, no pressure.