How Much Does Stiolto Respimat Cost with Medicare?

Hey there if you're reading this, chances are you or someone you love relies on Stiolto Respimat to manage COPD. And honestly, we get it every time that prescription bottle lands in your hands, it can feel like you're holding a month's worth of groceries instead of medicine. I've talked to plenty of people who've felt that same sinking feeling when they see the price tag.

But here's the good news that might make you breathe a little easier: things are changing. Big changes in how Stiolto is priced, plus the right Medicare coverage, can dramatically reduce what you're paying out of pocket. So grab a cup of tea, settle in, and let's chat about how you can find relief not just for your lungs, but for your wallet too.

Out-of-Pocket Costs Explained

Let's start with the big news that's been making waves: in June 2024, Boehringer Ingelheim, the company that makes Stiolto Respimat, put a cap on the list price at $35 per inhaler. That's right no more shocking bills that creep up toward $600 or more like they used to.

Now, before you start celebrating, let me paint the full picture. That $35 cap is the manufacturer's list price think of it as the maximum sticker price before any insurance discounts. For those with Medicare, the story gets even better. Many folks are finding their actual out-of-pocket costs are much lower than that $35 mark, sometimes even as low as $0 to $10 per month. How's that for a pleasant surprise?

But here's what you should know your final cost depends on a few moving pieces: which tier your inhaler falls into on your plan's formulary, whether you've met your annual deductible, and if your income affects your Medicare premiums. It's kind of like ordering at a restaurant the menu price isn't always what you end up paying.

How Medicare Steps In

Understanding how Medicare covers Stiolto Respimat can feel like trying to solve a puzzle while blindfolded, but I promise it's not that complicated. Your two main options for coverage are Medicare Part D and Medicare Advantage plans that include prescription drug benefits.

Think of Part D as the classic add-on coverage for prescriptions you can pair it with Original Medicare. Medicare Advantage plans, on the other hand, are like the all-in-one package deals that include your medical coverage, hospital stays, and often, prescription drugs too. Most people find that one of these two options covers Stiolto Respimat, but here's the kicker not all plans are created equal.

You might be thinking, "Wait, if the price is already capped at $35, why would I pay less?" Great question! It's all about how your specific plan negotiates with insurance companies and where Stiolto falls on their formulary tiers. Some plans have already placed it in preferred categories, which means you're looking at those rock-bottom copays we mentioned earlier.

I remember talking to Sarah, a friend of mine who was terrified about her monthly medication costs. She was paying nearly $70 out of pocket every month. When she checked her plan details more carefully, she discovered her copay had dropped to just $5. The look of relief on her face? Priceless.

Additional Ways to Save

Even with Medicare coverage, there are still some extra tricks up our sleeve. Did you know Boehringer Ingelheim offers a patient assistance program called BI Cares? It's like having a secret weapon in your back pocket. For folks who are uninsured or underinsured, this program can potentially provide Stiolto Respimat for free. That's right completely free.

And for those paying cash without insurance, discount cards from services like GoodRx or SingleCare can shave hundreds of dollars off that retail price tag. I know someone who went from paying around $650 down to about $450 a month still not cheap, but certainly more manageable.

Let's take a moment to put these numbers into perspective:

Inhaler	Without Insurance (Avg)	With Medicare/Discount Card
Stiolto Respimat	~$631	~$0$35
Advair Diskus	~$544	~$48
Symbicort	~$508	~$94

As you can see, the savings with proper coverage can be absolutely life-changing. And remember, these numbers can vary based on where you live and which pharmacy you use.

Important Details to Remember

Here's where things get a bit more nuanced. Not every Medicare plan automatically covers Stiolto Respimat kind of like how not every health food store carries your favorite brand of tea. During open enrollment, take a few minutes to check your plan's formulary, which is basically their grocery list of covered medications.

Some plans might also require what's called prior authorization. This just means your doctor needs to send in some paperwork to show why Stiolto is medically necessary for you. It sounds bureaucratic and intimidating, but in reality, it's usually a simple form your doctor's office can complete while you're waiting for your appointment.

Here are a few pro tips I've picked up from chatting with other people navigating these waters:

• Keep tabs on where you are in your plan's "donut hole" yep, Medicare has its own jargon! This coverage gap can affect your costs throughout the year.
• Understand whether your inhaler is considered a maintenance drug in your plan this can impact how you save.
• Don't be shy about asking your doctor to check if there are lower-cost alternatives that work just as well for your specific situation.

Is Stiolto Worth It?

Let's have a real talk moment. Why was Stiolto Respimat so expensive in the first place? Well, for years, inhaler pricing was kind of like the Wild West no caps, patent protections preventing cheaper generics, and manufacturers with significant pricing power. You might have felt like you were being held hostage by a system that seemed designed to make breathing expensive.

You might be wondering if there's a generic version available yet. Unfortunately, not as of 2025. But here's some hope on the horizon industry experts expect generics could potentially hit the market by 2027 at the earliest. Until then, we work with what we have, and right now, the tools to make Stiolto more affordable are better than they've ever been.

If you're still finding that Stiolto feels too expensive even with all these options, don't throw in the towel. Talk to your doctor about formulary-matching drugs there might be similar combination inhalers that cost significantly less. Breo Ellipta or Anoro Ellipta could be worth discussing, especially if they're preferred in your plan.

Also consider reaching out to patient assistance programs from other manufacturers. Sometimes you can find support in unexpected places, and these programs don't always get the attention they deserve.

Final Thoughts on Affordability

Look, I won't sugarcoat it managing COPD and its medications can feel overwhelming, especially when you're worried about the financial side of things. I've heard from so many people who describe that moment when they realize how much their medication costs as a "punch to the gut." But knowing what you know now, I hope you feel at least a little more armed with information and options.

Stiolto Respimat might not be the cheapest medication out there, but we're in a very different landscape now than we were even a year ago. With manufacturer price caps, Medicare coverage options, and various assistance programs, getting the medication you need doesn't have to mean choosing between your health and your financial stability.

I'd encourage you to take a close look at your plan documents specifically your 2025 Evidence of Coverage to understand exactly what you're entitled to. Call your pharmacist and have a conversation about which options work best in your area. Reach out to your doctor's office about any prior authorization requirements or alternative suggestions.

You're not alone in this. We've all been in those moments where we've stared at a prescription bottle wondering how we'll make it work. But we've also celebrated those moments when we discover that new insurance year or find that patient assistance program that changes everything.

So here's my challenge to you: Don't just take my word for it. Check your plan details, make those calls, and ask those questions. Information is power, especially when it comes to your health. And if you ever need someone to talk through this with, remember that community matters. Share your experiences, ask questions, and know that others have walked this path before you.

After all, every breath matters not just for your physical health, but for your peace of mind too. You've got this, and you're taking exactly the right steps by getting informed and seeking solutions. That in itself is something to feel proud of.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.