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Does Medicare Cover Piqray?

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By Daniel Petkevich
Dec 2, 2022

All Part D plans have you covered

For Medicare beneficiaries seeking treatment for breast cancer, knowing that you have coverage can offer peace of mind amidst very challenging times. If you are taking Piqray to treat your breast cancer, the good news is that all Part D prescription drug plans offer coverage. How much could it cost you? Let's find out.

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What is Piqray and what are its uses?

Piqray is a targeted therapy used to treat certain types of advanced or metastatic breast cancer. It works by blocking an enzyme called PI3K, which may help slow or stop the growth of some cancer cells. When taken in combination with other chemotherapy drugs, it can be an effective treatment option for breast cancer patients.

How does Medicare cover Piqray?

Most Part D plans offer coverage for Piqray. This means that if your doctor prescribes this medication, it should be covered by your Medicare plan. However, the amount of coverage will depend on the specific plan you have and its drug formulary. Before you start treatment, it's important to check with your insurance provider to make sure you're fully aware of what's covered and how much you'll need to pay out of pocket.

How much does Piqray cost on Medicare?

The cost of Piqray on Medicare depends on the Part D plan you have and which tier it has placed the drug in. Generally, generic drugs are less expensive than brand-name drugs and may be covered at a lower co-pay or co-insurance amount. Piqray will typically be found on Tier 5, which is usually the most expensive. How much you will pay will also depend on

your coverage phase

. It's also important to note that if you're enrolled in a Medicare Advantage Plan, your coverage and cost may differ. Speak to your doctor and insurance provider for more personalized information about how much you would pay.

Can I get help paying for Piqray?

There are several programs available that may be able to help you with the costs associated with taking Piqray. Your doctor may be aware of other resources, or your insurance provider may be able to direct you to programs that can help. Additionally, you may qualify for Extra Help from Medicare, which could lower the cost of your medications and healthcare services.

If you have questions about Medicare coverage of Piqray, who can you ask for help?

If you have questions about Medicare coverage of Piqray, one of the best resources is your doctor. Your doctor can provide personalized advice about your specific situation and help answer any questions or concerns you may have. Additionally, speaking to your insurance provider can also be helpful. They can provide more detailed information on what your plan covers and how much you might need to pay out-of-pocket for Piqray. You can also contact the Medicare helpline at 1-800-MEDICARE (1-800-633-4227) for more information. They have knowledgeable representatives who can help guide you through your coverage options.

Takeaway

Piqray is a prescription drug covered by most Part D plans. Depending on the specifics of your coverage, you may need to pay out-of-pocket for this medication. If you are having difficulty covering the costs associated with Piqray, several programs can help. Be sure to talk with your doctor before starting or stopping any medication (including Piqray). This content is for informational purposes only. Give us a call at Fair Square Medicare for all your Medicare questions.

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Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

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