Crestor (Rosuvastatin) Cost in Maryland: Prices, Insurance, and Savings in 2026

What Rosuvastatin Actually Costs in Maryland Right Now

Generic rosuvastatin has become one of the most affordable statins available at Maryland pharmacies. The average cash-pay price across the state in 2026 sits around $15 per month for a 30-day supply at standard doses. Brand-name Crestor from AstraZeneca carries a manufacturer list price near $290 per month.

That gap matters. A patient filling brand Crestor without insurance pays roughly 19 times more than someone filling the generic equivalent. The active molecule is identical: rosuvastatin calcium in the same tablet strengths (5 mg, 10 mg, 20 mg, and 40 mg). According to the FDA-approved prescribing information, all approved rosuvastatin products must meet the same bioequivalence standards [1].

Prices do vary by pharmacy. Costco and Walmart locations in Baltimore, Silver Spring, and Annapolis tend to price generic rosuvastatin between $9 and $18 for a 30-day supply. Independent pharmacies may charge slightly more. Checking GoodRx or RxSaver before filling can reveal $4 to $8 differences between stores within the same zip code.

For patients already on stable doses, 90-day fills through mail-order pharmacies often reduce per-tablet cost by an additional 10% to 20%. Express Scripts and CVS Caremark both offer 90-day generic rosuvastatin fills that bring the effective monthly cost below $10 for many Maryland residents.

Maryland Medicaid Coverage for Crestor and Rosuvastatin

Maryland Medicaid covers Crestor, but the program requires prior authorization before it will pay for the brand-name product. Generic rosuvastatin is on the Maryland Medicaid preferred drug list and typically does not require prior authorization at standard doses.

The prior authorization process for brand Crestor generally requires documentation that the patient has tried and failed generic rosuvastatin, or that a specific clinical reason (such as an allergy to an inactive ingredient in the generic formulation) justifies the brand product. Maryland's Medicaid pharmacy program follows the American College of Cardiology/American Heart Association guidelines on cholesterol management when evaluating PA requests for high-intensity statins [2].

Patients enrolled in Maryland HealthChoice managed care organizations (MCOs) such as CareFirst, Priority Partners, or Amerigroup should verify formulary placement with their specific plan. Most MCOs mirror the state Medicaid preferred drug list, but copay tiers can differ. Generic rosuvastatin copays under Maryland Medicaid MCOs typically range from $1 to $3 per fill. Brand Crestor, if approved through PA, may carry a copay of $3 to $5.

Maryland expanded Medicaid eligibility under the Affordable Care Act, and the state covers adults with household incomes up to 138% of the federal poverty level. For those who fall just above the Medicaid threshold, Maryland Health Connection marketplace plans often include generic rosuvastatin on Tier 1 formularies with copays under $10.

Which Maryland Insurance Plans Cover Crestor?

Most commercial insurance plans sold in Maryland cover generic rosuvastatin on their lowest formulary tier. Brand-name Crestor coverage varies. CareFirst BlueCross BlueShield, the largest insurer in the state, places generic rosuvastatin on Tier 1 with copays between $5 and $15, depending on the specific plan.

The picture shifts for brand Crestor. Many commercial plans in Maryland have moved brand Crestor to Tier 3 (non-preferred brand) or excluded it entirely, given the wide availability of generics. Patients with plans through Cigna, Aetna, or UnitedHealthcare in Maryland should expect similar tiering structures. A Tier 3 copay for brand Crestor can run $50 to $75 per month, and some plans require step therapy through the generic first.

Federal employee health benefit (FEHB) plans, which cover a large number of Maryland residents given the state's proximity to Washington, D.C., generally include generic rosuvastatin with low copays. The Blue Cross Blue Shield Standard Option and GEHA plans both list it on their preferred generic tiers.

Medicare Part D plans in Maryland also cover rosuvastatin widely. Under the Inflation Reduction Act's $2,000 annual out-of-pocket cap that took full effect in 2025, Medicare beneficiaries filling generic rosuvastatin will rarely approach that threshold from statins alone, given the low per-fill cost [3]. Patients on multiple branded medications, however, benefit significantly from the cap.

Compounded Rosuvastatin in Maryland: Legality and Access

Compounded rosuvastatin is legal in Maryland when prepared by a licensed 503A compounding pharmacy operating under a valid patient-specific prescription. Maryland's Board of Pharmacy regulates compounding under COMAR 10.34.19, aligning with FDA guidance on 503A compounding under Section 503A of the Federal Food, Drug, and Cosmetic Act [4].

A 503A pharmacy compounds medications for individual patients based on prescriptions from licensed practitioners. This is distinct from 503B outsourcing facilities, which can produce larger batches without patient-specific prescriptions. Both pathways exist in Maryland, though 503A is more common for statin compounding.

Why would anyone compound rosuvastatin when the generic tablet costs $15? Several clinical scenarios justify it. Patients who need a dose not commercially available (say, 7.5 mg), those who cannot swallow tablets and need a liquid suspension, or patients with documented allergies to specific dyes or fillers in manufactured tablets may benefit from compounded formulations. Pediatric patients with familial hypercholesterolemia sometimes require compounded liquid rosuvastatin because commercial liquid formulations are limited.

Pricing for compounded rosuvastatin varies by pharmacy. Some 503A pharmacies in the Baltimore and D.C. metro areas offer compounded rosuvastatin at minimal markup when bundled with telehealth consultations or membership-based pharmacy models. Patients should confirm that their compounding pharmacy holds a current Maryland Board of Pharmacy license and that the prescribing provider has evaluated them appropriately.

Discount Programs and Savings Cards for Maryland Patients

AstraZeneca's savings card for brand Crestor can reduce out-of-pocket costs for commercially insured patients. The card typically brings copays to $0 to $3 per fill. Patients on government insurance (Medicare, Medicaid, Tricare, VA) are not eligible for manufacturer savings cards under federal anti-kickback statutes.

For generic rosuvastatin, discount cards from GoodRx, SingleCare, and RxSaver often match or beat insurance copays. This is not unusual. A GoodRx coupon for rosuvastatin 10 mg (30 tablets) at CVS in Baltimore may show a price of $8 to $12, while the same patient's insurance copay might be $15. Pharmacists in Maryland can process whichever price is lower at the point of sale.

Maryland law supports this practice. The state enacted legislation allowing pharmacists to inform patients when a cash price or discount card price is lower than their insurance copay, a provision sometimes called "gag clause" protection. This means your pharmacist can proactively tell you about a cheaper option rather than silently running the more expensive insurance claim.

The 2019 ACC/AHA Guideline on Primary Prevention of Cardiovascular Disease explicitly recommends discussing cost barriers with patients as part of the shared decision-making process for statin therapy [5]. If medication cost creates adherence barriers, prescribers should explore lower-cost alternatives within the statin class or connect patients with assistance programs.

Additional programs available to Maryland residents include:

• NeedyMeds: maintains a database of patient assistance programs for rosuvastatin and other statins
• Maryland 211: the state's health and human services referral line, which can connect patients to local pharmacy assistance programs
• Rx Outreach: a mail-order pharmacy offering generic medications at reduced prices to qualifying low-income patients nationwide

Getting Rosuvastatin via Telehealth in Maryland

Maryland permits telehealth prescribing of rosuvastatin without restrictions. A provider licensed in Maryland can evaluate a patient via video or audio visit, review lipid panels and cardiovascular risk factors, and prescribe rosuvastatin electronically to any Maryland pharmacy.

The state's telehealth parity law, which was strengthened during the COVID-19 pandemic and made permanent through legislation in 2021, requires insurers to cover telehealth visits at the same rate as in-person visits. This means a Maryland patient can consult with a telehealth provider, receive a rosuvastatin prescription, and have it filled at their local pharmacy without ever visiting a brick-and-mortar clinic.

Several telehealth platforms serve Maryland patients for statin prescriptions and cardiovascular risk management. HealthRX offers consultations with board-certified clinicians who can prescribe rosuvastatin and monitor lipid panels through periodic lab work. The process typically involves an initial evaluation of cardiovascular risk using the Pooled Cohort Equations recommended by ACC/AHA guidelines [6], followed by prescription and ongoing monitoring.

The JUPITER trial (N=17,802), published in the New England Journal of Medicine, demonstrated that rosuvastatin 20 mg reduced the incidence of major cardiovascular events by 44% compared to placebo in patients with elevated hsCRP and LDL cholesterol below 130 mg/dL [7]. That trial changed clinical practice by expanding the population eligible for statin therapy beyond those with traditionally elevated LDL levels. Telehealth platforms can identify these at-risk patients through lab review and initiate rosuvastatin when appropriate.

For ongoing monitoring, the ACC/AHA guidelines recommend checking a fasting lipid panel 4 to 12 weeks after starting rosuvastatin, then every 3 to 12 months as clinically indicated. Maryland telehealth providers can order labs at Quest, Labcorp, or local hospital-affiliated draw sites, review results remotely, and adjust doses without requiring an in-person visit.

Rosuvastatin Dosing and What to Expect on Therapy

Rosuvastatin is prescribed once daily, with or without food, at any time of day. Starting doses range from 5 mg to 20 mg depending on the patient's baseline LDL, cardiovascular risk, and treatment goals. The maximum approved dose is 40 mg daily, reserved for patients who do not reach their LDL target on lower doses.

At the 10 mg dose, rosuvastatin reduces LDL cholesterol by approximately 46%, according to the FDA-approved prescribing information [1]. The 20 mg dose achieves roughly 52% LDL reduction, and the 40 mg dose reaches approximately 55%. These reductions are dose-dependent but not linear. Doubling the dose from 10 mg to 20 mg provides an additional 6 percentage points of LDL lowering, following the "rule of 6" observed across the statin class.

The 2018 ACC/AHA Cholesterol Guideline categorizes rosuvastatin 20 mg to 40 mg as high-intensity statin therapy and rosuvastatin 5 mg to 10 mg as moderate-intensity [2]. Patients with clinical atherosclerotic cardiovascular disease (ASCVD) or an LDL of 190 mg/dL or higher should generally receive high-intensity therapy. Those with diabetes aged 40 to 75 or a 10-year ASCVD risk of 7.5% or greater are candidates for moderate-to-high-intensity therapy.

Common side effects include myalgia (muscle pain without CK elevation), which occurs in roughly 5% to 10% of patients across statin trials. Serious adverse effects such as rhabdomyolysis are rare, occurring in fewer than 1 in 10,000 patient-years. The SLCO1B1 genotype influences rosuvastatin pharmacokinetics and may affect myopathy risk, though routine pharmacogenomic testing before statin initiation is not yet standard practice [8].

Patients of Asian descent may have higher rosuvastatin exposure at the same dose. The FDA label recommends a starting dose of 5 mg in Asian patients, with dose titration based on response and tolerability.

How Maryland Compares to Neighboring States

Generic rosuvastatin pricing in Maryland is broadly similar to prices in Virginia, Pennsylvania, Delaware, and the District of Columbia. Regional competition among chain pharmacies (CVS, Walgreens, Rite Aid, Walmart) keeps generic statin pricing relatively uniform across the mid-Atlantic corridor.

Maryland does differ from some neighboring states in its Medicaid formulary structure. Virginia Medicaid, for example, uses a different preferred drug list vendor, which can result in different prior authorization requirements for brand-name statins. Pennsylvania's Medicaid program covers rosuvastatin similarly to Maryland but uses different MCOs with their own formulary nuances.

For patients who live near state borders (common in the D.C. metro area, the Eastern Shore, or the western panhandle), filling prescriptions across state lines is legal. A Maryland patient can fill a prescription at a Virginia or D.C. pharmacy if the price is lower, provided the pharmacy accepts their insurance or discount card. The prescription must be written by a provider licensed in the state where the patient was evaluated, and the dispensing pharmacy must be licensed in its own state.

Dr. Seth Martin, a preventive cardiologist at Johns Hopkins Medicine, has noted: "Statins remain the most cost-effective cardiovascular intervention we have. When a medication that reduces heart attack risk by 25% to 35% costs less than a daily coffee, the barrier is awareness, not access" [9].

The Cochrane Collaboration's 2013 meta-analysis of statins for primary prevention found that statin therapy reduced all-cause mortality by 14% (RR 0.86, 95% CI 0.79 to 0.94) and major cardiovascular events by 27% (RR 0.73, 95% CI 0.67 to 0.80) in populations without established cardiovascular disease [10]. At $15 per month for generic rosuvastatin, the cost per quality-adjusted life year (QALY) falls well below conventional willingness-to-pay thresholds.

Practical Steps to Get the Lowest Price in Maryland

Start with generic rosuvastatin. There is no clinical reason to use brand Crestor unless a documented intolerance to generic inactive ingredients exists. Ask your prescriber to write for "rosuvastatin" rather than "Crestor" to avoid pharmacy-level substitution complications.

Check discount card prices before using insurance. Run your prescription through GoodRx, SingleCare, and RxSaver. Compare prices at two or three pharmacies in your area. Costco pharmacy does not require a membership for prescription fills in Maryland.

If you have Maryland Medicaid, generic rosuvastatin should be available with a minimal copay and no prior authorization. If your provider wants you on brand Crestor, expect a PA process that takes 24 to 72 hours.

For 90-day fills, ask your prescriber to write a 90-day supply with refills. Mail-order through your insurance plan's preferred pharmacy typically offers the lowest per-unit cost for maintenance medications like rosuvastatin. CVS Caremark, Express Scripts, and OptumRx all serve Maryland patients for mail-order statin fills.

The ACC/AHA guidelines recommend checking liver function tests (ALT) before starting rosuvastatin and repeating only if clinically indicated, not routinely [2]. This reduces lab costs associated with therapy initiation. A baseline fasting lipid panel and ALT can be drawn at the same visit that produces the rosuvastatin prescription, whether that visit happens in person or via telehealth.

Rosuvastatin 10 mg taken once daily at any consistent time produces a median LDL reduction of 45.8%, and the generic version of that tablet costs Maryland residents roughly $0.50 per day [1].