How much does Xarelto cost with Medicare in Colorado in 2027?

Xarelto (rivaroxaban) is a factor Xa inhibitor (a direct oral anticoagulant), the same family as Eliquis. Besides stroke prevention in atrial fibrillation and clot treatment, a low 2.5 mg dose is used with aspirin to cut the risk of major events in coronary or peripheral artery disease. In 2024, 6,849 Colorado prescribers wrote it for 22,107 Part D members. 2027 is a transition year, so check how your plan handles brand versus generic.

Xarelto under Medicare Part D in 2027: removal, generic approvals and Colorado use

Xarelto	Amount
Medicare negotiated price, 2027	None (removed January 1, 2027)
What changed: the 2026 negotiated price, 30 days	$197
2027 maximum deductible / out-of-pocket cap	$700 / $2,400
Colorado Part D members who filled Xarelto (2024)	22,107
Colorado gross cost per 30-day fill (2024)	$526.75
Colorado patient share per 30-day fill (2024)	$54.53
First generic approval, 2.5 mg tablets	March 3, 2025
First generic approvals, atrial fibrillation use	May 14, 2025
Removed from negotiation	January 1, 2027

Generic rivaroxaban: what FDA approved

FDA approved the first generics of Xarelto 2.5 mg tablets, from Lupin and Taro, on March 3, 2025. On May 14, 2025 it added nine more first-generic rivaroxaban tablet approvals for reducing stroke risk in nonvalvular atrial fibrillation, and a generic oral suspension followed in June 2025. FDA reminds readers that an approval does not guarantee a product is on pharmacy shelves, so ask your pharmacist which strengths are actually stocked.

What the 2027 removal means for your plan

CMS determined in October 2025 that Xarelto leaves the negotiation program effective January 1, 2027. CMS takes that step once a generic naming the brand as its reference is approved and marketed. For 2027, the $197 figure no longer applies, and each plan decides whether brand Xarelto, generic rivaroxaban or both are on its drug list, and on which tier.

Spending was already shifting. Nationally, 1,258,760 people with Part D used Xarelto in 2025, at $1,006.21 gross per claim; in the first quarter of 2026 the per-claim figure was $374.04.

What a 2027 year can cost

For 2027 no Medicare price is published for brand Xarelto, so a yearly figure cannot be worked out honestly from a single price. What is fixed by the 2027 standard design: your plan's drug deductible can be no more than $700, you then pay 25% coinsurance or your tier's copay, and your own out-of-pocket cost for covered drugs stops at $2,400 for the year. If your plan covers generic rivaroxaban on a lower tier, the share applies to a smaller price.

What changed from 2026: at the $197 negotiated price and a $615 deductible, a 2026 year came to $1,052.25. That price ends December 31, 2026.

Help with the bill

The XARELTO withMe Savings Card is for commercially insured patients. The Janssen cost page lists Extra Help and the Johnson & Johnson Patient Assistance Program for Medicare members. The program considers Part D members who show they are not eligible for the Low-Income Subsidy and spend more than 4% of gross household income on prescriptions (833-742-0791).

If your 2027 plan drops brand Xarelto

Part D plans must give a new member a temporary transition fill when a drug they already take is not on the plan list, which buys time to switch to a covered version or to file a coverage exception with your prescriber. Do not let the bottle run out before you know which rivaroxaban your 2027 plan covers.

In Colorado during 2024, 175,811 thirty-day fills of Xarelto cost $92,609,426 gross; members paid $9,587,503 of that, an average of $433.69 per person over the year.

Short courses after hip or knee surgery

Orthopedic surgeons often send patients home after a hip or knee replacement with a short course of rivaroxaban lasting weeks rather than months. A course that brief usually lands inside your drug deductible, so you may pay the full plan price for it. In 2027 the plan sets that price, so ask before surgery which version the plan covers and what it charges, so the discharge prescription is not a surprise.

Related questions

Sources

1. CMS: Selected drugs and negotiated prices Centers for Medicare & Medicaid Services
2. CMS Selected Drug List and Negotiated Prices (Maximum Fair Price) data file, September 21, 2026 Centers for Medicare & Medicaid Services
3. CMS Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies Centers for Medicare & Medicaid Services
4. CMS Medicare Part D Prescribers by Geography and Drug, 2024 (Colorado) Centers for Medicare & Medicaid Services
5. CMS fact sheet: negotiated prices for initial price applicability year 2026 Centers for Medicare & Medicaid Services
6. CMS Medicare Quarterly Part D Spending by Drug Centers for Medicare & Medicaid Services
7. CMS: How much does Medicare drug coverage cost? Centers for Medicare & Medicaid Services
8. FDA Roundup: March 4, 2025 U.S. Food and Drug Administration
9. FDA: 2025 First Generic Drug Approvals U.S. Food and Drug Administration
10. Janssen: Xarelto cost and support Janssen Pharmaceuticals

Please note: We do not offer every plan available in your area. Currently we represent 10 organizations which offer 106 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Headwaters Health and Wealth is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.