Medicare may cover Vraylar (cariprazine) if you have a plan with prescription drug benefits, such as a Part D plan or a Medicare Advantage (Part C) plan.
Vraylar is a brand-name drug that doctors may prescribe to treat bipolar disorder and certain other mental health conditions.
Vraylar belongs to a group of drugs called atypical antipsychotics. The Food and Drug Administration (FDA) has approved the drug to treat the following conditions:
- mixed or manic episodes in adults with bipolar I disorder
- major depressive disorder in adults, when prescribed along with an antidepressant
- bipolar depression in adults with bipolar I disorder
- schizophrenia in adults
To receive coverage for Vraylar, you need to be a Medicare prescription drug plan enrollee.
If you have Original Medicare (parts A and B), you can enroll in a stand-alone Part D plan to cover your medications.
If you have a Medicare Advantage plan, you may have prescription drug coverage as part of your plan. However, not all Medicare Advantage plans include drug benefits.
Private insurance companies offer Medicare drug plans. Their lists of covered drugs differ. Your plan may cover Vraylar if it’s in the plan’s formulary. Most Part D plans cover Vraylar.
Certain drugs are protected class medications, meaning Medicare must cover them. Antipsychotics are a protected class.
Review your plan’s documentation or contact a representative to learn whether it covers Vraylar. If it doesn’t, it may cover an alternative medication.
Medicare offers a coverage finder tool to allow users to find plans in their area that include coverage for Vraylar.
The amount you pay for Vraylar may depend on several factors, including your plan and location and the drug’s tier.
Medicare prescription drug plans group covered drugs into cost tiers. Vraylar is typically a higher tier drug without a generic version.
According to the drug’s manufacturer, the wholesale acquisition cost of a 30-day supply of Vraylar is $1,518.88.
The amount you pay for Vraylar may also depend on your coverage stage.
Most Part D plans have three stages of coverage. Beneficiaries may have different out-of-pocket expenses depending on the stage:
- Deductible stage: If your plan has a deductible, you must pay the full medication cost until you reach your deductible amount. In 2025, the maximum deductible amount for a Part D plan is $590.
- Initial coverage stage: After meeting your deductible, you must pay a 25% coinsurance on covered medications until your out-of-pocket costs reach $2,000.
- Catastrophic stage: Once you spend $2,000 in a calendar year, you may pay no more for covered medications. In 2026, the out-of-pocket maximum may be $2,100.
Your costs may be lower if you qualify for cost assistance through the Extra Help program.