Does Medicare Cover Piqray?
Fair Square Medicare

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.


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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