Medicare and Cosentyx coverage
The Food and Drug Administration (FDA) has approved Cosentyx (secukinumab) injections to treat several inflammatory conditions. Adults and certain children can receive this medication to treat conditions such as moderate to severe plaque psoriasis, active psoriatic arthritis, and ankylosing spondylitis.
When a person is enrolled in Medicare, the Medicare part or plan that covers their Cosentyx prescription will depend on how they need to receive this drug.
Medicare Part D or Medicare Advantage Prescription Drug (MAPD) plans cover self-administered prescription drugs. This means that a Medicare beneficiary prescribed Cosentyx self-injections will need to be covered by one of these plans.
However, although Medicare approves these plans, they are managed by private insurers. This means that a person’s coverage of Cosentyx depends on their specific plan and its formulary, which is the list of the plan’s covered medications.
Original Medicare (parts A and B) typically covers medications that cannot be self-administered. So when a patient receives Cosentyx as an intravenous (IV) infusion in an outpatient clinic, Medicare Part B should cover it. If the patient is in the hospital at the time of needing it, Part A should cover the drug.
Those insured by Medicare Advantage (Part C) should receive equivalent coverage for Cosentyx infusions as they would under Original Medicare.
From July 2025, Cosentyx costs $7,936.48 per month for a self-injection package and $4,401.32 for each IV infusion.
With an infusion, Medicare Part B covers 80% of this cost after a person meets the $257 annual deductible. A person also has to pay a monthly premium starting at $185, depending on income.
Medicare Advantage (Part C) plans offer different premiums, deductibles, and coinsurance rates. A person must also pay the Part B premium to enroll in a Part C plan, though some Part C plans cover this cost.
Similarly, Part D plans have different premiums and deductibles. In addition, a person’s out-of-pocket costs under a Medicare drug plan depend on the drug’s tier within the plan. Generic drugs tend to cost less, but Cosentyx does not have a generic version.
That said, Medicare drug plans cap annual prescription costs at $2,000 in 2025, after which the plan should cover all of the person’s remaining medication expenses for the year. This cap changes yearly, with an expected increase to $2,100 in 2026. In addition, no Medicare drug plan deductible exceeds $590 in 2025.