Prescription costs with Medicare

How much is Entresto with Medicare in Arizona in 2026?

Medicare's negotiated price for a 30-day supply of Entresto is $295 in 2026, down from a $628 list price, and your Part D cost depends on your plan's deductible and tier, with covered drug costs capped at $2,100 for the year.

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These are national Medicare figures from CMS, not Arizona-only prices. Entresto is used to treat certain types of heart failure. What you pay at a pharmacy in Chandler or anywhere in Arizona depends on your plan's deductible, the tier Entresto sits on, and whether you have reached the yearly cap.

Entresto under Medicare Part D: price and cost figures
MeasureFigure
Medicare negotiated price, 30-day supply (2026)$295
List price CMS reported before negotiation, 30-day supply$628
Average gross Part D cost per claim, 2025 (national)$1,077.74
Average gross Part D cost per claim, Q1 2026 (national, preliminary)$325.48
People with Part D who used it in 2025 (national)826,563
Part D out-of-pocket cap, 2026 / 2027$2,100 / $2,400
Source: CMS Medicare Quarterly Part D Spending by Drug (gross cost before rebates, national); CMS negotiated price fact sheets; CMS CY2027 landscape for the 2027 cap. Retrieved October 13, 2026.

How Part D pricing works for this drug

Your plan pays the pharmacy a negotiated price, and your share comes in three steps, in this order:

Step 1, the deductible: you pay the full negotiated price until your plan's deductible is met. The highest Part D deductible in the CMS landscape for Maricopa County is $615 for 2026 and $700 for 2027. Some plans have a lower deductible or none on certain tiers.

Step 2, your tier: after the deductible you pay the copay (a flat dollar amount) or coinsurance (a percentage of the price) set by the tier Entresto sits on in your plan.

Step 3, the yearly cap: once your out-of-pocket drug spending reaches $2,100 in 2026 ($2,400 in 2027), you pay $0 for covered Part D drugs for the rest of the year.

In 2025, 826,563 people with Part D filled Entresto, at an average gross cost of $1,077.74 per claim. A claim can be a 30-day or 90-day fill, so treat that as a guide to scale, not a monthly bill.

What changes the answer

Entresto is changing fast. CMS lists it as removed from the negotiation program effective January 1, 2027, which happens once a generic is marketed, and brand-name claims have dropped: 826,563 people with Part D used Entresto in 2025, against 103,676 in the first quarter of 2026. Ask whether generic sacubitril/valsartan is on your 2027 plan and on which tier.

Formularies are set plan by plan. The 2027 drug lists are published by each plan for Annual Enrollment, and CMS has not yet released its 2027 formulary files, so check your own plan's 2027 list and tier. People with limited income can apply for Extra Help through Social Security, which lowers drug copays.

What to do next

Bring your prescription list to a plan review. During Annual Enrollment, October 15 to December 7, 2026, we compare how Entresto is covered on the 2027 plans we offer in Maricopa and Pinal counties, including tier, deductible and pharmacy, and show you the yearly total rather than one copay.

Related questions

How much is Entresto with Medicare in Arizona in 2026?

Medicare's negotiated price for a 30-day supply of Entresto is $295 in 2026, down from a $628 list price, and your Part D cost depends on your plan's deductible and tier, with covered drug costs capped at $2,100 for the year.

Is Entresto covered by Medicare?

Entresto is covered under Medicare Part D drug plans and Medicare Advantage plans with drug coverage when it is on the plan's formulary. Coverage, tier and any prior authorization vary by plan.

What is the most I can pay for Part D drugs in a year?

$2,100 in 2026 and $2,400 in 2027 for covered Part D drugs. After that you pay $0 for covered drugs for the rest of the year.

Does the Part D deductible apply to Entresto?

It can. Until your plan's deductible is met, you may pay the full negotiated price for Entresto. Deductibles are set plan by plan, and some plans have a lower deductible or none on certain tiers, so compare where Entresto sits on each plan's 2027 drug list, not just the premium.

Can Extra Help lower what I pay for Entresto?

Yes, if you qualify. Extra Help is a federal program, applied for through Social Security, that lowers Part D premiums, deductibles and copays for people with limited income and resources. In Arizona, people with full AHCCCS coverage or a Medicare Savings Program usually get it automatically. We can help you check.

Can I spread my Entresto costs over the year?

Yes. The Medicare Prescription Payment Plan lets you pay your out-of-pocket Part D drug costs in monthly amounts across the calendar year instead of all at once at the pharmacy. It does not lower the total you pay, but it can help when a deductible or high copay lands early in the year. Ask your plan to sign you up.

How do I check whether my 2027 plan covers Entresto?

Look up Entresto on each plan's 2027 drug list, called the formulary, and note the tier and any prior authorization or quantity limits. During Annual Enrollment, October 15 to December 7, 2026, we can compare it across the 2027 plans we offer in Maricopa and Pinal counties and show you the yearly total.

Will I pay the Medicare negotiated price for Entresto at the pharmacy?

Not exactly. The negotiated price is what your plan's cost for Entresto is based on. You pay that price only while you are in your deductible; after that you pay your tier's copay or coinsurance, until the yearly out-of-pocket cap stops your costs for covered drugs.

Is there a generic for Entresto under Medicare?

CMS lists Entresto as removed from the negotiation program from January 1, 2027, which the program does when a generic is marketed. Check your 2027 plan for generic sacubitril/valsartan.

Sources

  1. CMS Medicare Quarterly Part D Spending by Drug Centers for Medicare & Medicaid Services
  2. CMS fact sheet: negotiated prices for initial price applicability year 2026 Centers for Medicare & Medicaid Services
  3. CMS: Selected drugs and negotiated prices Centers for Medicare & Medicaid Services
  4. CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services

Please note: We do not offer every plan available in your area. Currently we represent 34 organizations which offer 64 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.Rise Up Benefits Group is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.

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