Xarelto (rivaroxaban) is an anticoagulant (a “blood thinner”). The question “what tier” usually refers to a drug’s cost tier on a specific health plan’s formulary (for example, preferred generic vs. brand, or a Medicare Part D tier), and that tier can vary by insurer and by state/plan.
What “tier” usually means for Xarelto
Drug tiers are set by each insurance plan, not by the drug manufacturer. So Xarelto could land on different tiers depending on the formulary rules—most commonly as a non-preferred brand name or a higher-cost tier compared with generics.
How to find your exact tier for Xarelto
Check your plan’s formulary for “Xarelto” (and sometimes also “rivaroxaban,” if your plan lists it separately). If you share your plan type (Medicare Part D, employer plan, Medicaid, etc.) and the plan name, I can tell you what to look for and how to interpret the tier labels.
Possible related angles people mean by “tier”
Some people ask “tier” when they really mean one of these:
- Prior authorization requirement (do you need approval before covering Xarelto?)
- Step therapy (will the plan require you to try a different anticoagulant first?)
- Coverage status for specific strengths (e.g., 10 mg vs 20 mg)
- Whether “generic rivaroxaban” is covered on a lower tier than Xarelto
If you meant Medicare “drug tier” specifically
On Medicare Part D, tiers are commonly labeled something like Tier 1 (lowest) through Tier 5/6 (highest, varies by plan). Xarelto is often not Tier 1 because it’s a brand, but if your plan covers generic rivaroxaban on a lower tier, your out-of-pocket cost may be different depending on which version is on your formulary.
Quick next step
Tell me:
1) your insurance type (Medicare Part D, employer plan, Medicaid, Marketplace), and
2) the plan name (or a screenshot/text of the formulary entry for Xarelto),
and I’ll help you identify the exact tier and what it likely means for your copay.
Sources: None cited (you asked about an insurance formulary tier, which requires your specific plan information).