Does Medicare Cover Entresto?
Yes — Part D plans generally cover Entresto for heart failure.
Drug Coverage · Heart & Blood
Entresto (sacubitril/valsartan) is used for chronic heart failure.
Does Medicare cover Entresto?
Yes — Part D plans generally cover Entresto for heart failure. Covered when prescribed for chronic heart failure. Usually a brand tier; copay depends on the plan.
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
Brand tier (often Tier 3). Your exact tier — and copay — depend on the plan you choose, which is why matching the formulary to your medications matters.
| Drug | Used for | Covered by Medicare? | Typical formulary tier |
|---|---|---|---|
| Eliquis (apixaban) | blood clots and stroke prevention in AFib | Yes | Preferred brand (often Tier 3) |
| Xarelto (rivaroxaban) | blood clots and stroke prevention | Yes | Brand tier (often Tier 3) |
| Entresto (sacubitril/valsartan) | chronic heart failure | Yes | Brand tier (often Tier 3) |
| Repatha (evolocumab) | high cholesterol / cardiovascular risk (a PCSK9 inhibitor) | Yes, with conditions | Brand or specialty tier — varies by plan |
Prior authorization & plan rules
Prior authorization or step therapy applies on some plans. Entresto is among the drugs selected for Medicare price negotiation.
If it isn’t covered (or costs too much)
A plan review can improve coverage; ask us about manufacturer and foundation help.
- Help paying for Entresto — assistance programs and grants.
- Compare Part D plans that cover Entresto on a better tier.
- How drug tiers work · Extra Help for lower-income beneficiaries.
Related medications
- Does Medicare cover Repatha? — evolocumab
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 Entresto costs on your plan — and whether a different plan would cover it better. No cost, no pressure.
Frequently Asked Questions
Does Medicare cover Entresto?
Which part of Medicare covers Entresto?
What if my plan doesn’t cover Entresto?
Sources
- Medicare.gov — drug coverage (Part D) — Medicare.gov
Talk to a local, licensed agent
Rocco DeLuca can walk you through your options — free, no pressure.