Preval HealthCash Pay
Pay cash and start treatment without an insurance wait.
For adults who need a PCSK9 inhibitor and would rather skip the insurance process. A licensed clinician evaluates you by video and can prescribe Repatha, Praluent, Lipfendra or Lerochol, and your medicine ships through our pharmacy partner. You skip prior authorization and step therapy. Care costs $99 a month, and you pay for the medicine at its cash price.
Online, nationwide in the US. Protocols written by a board-certified preventive cardiologist.
For people who can't wait on insurance
Preval runs as a cash practice for people who would rather not wait on prior authorization, whose plan covers these medicines poorly, whose insurer said no, or who are uninsured.
A prior authorization can take weeks, even when the plan approves it on the first try. Some plans require months of step therapy first, and some barely cover advanced lipid medicines at all. Many people looking for a Repatha or Praluent savings card want a price they can see up front.
Cash pay uses the same evaluation and the same medicines, and you start without waiting on an insurance approval.
How It Works
From first questions to shipped medication
Sign up in a minute, see a licensed clinician by video to confirm it's a fit, get labs, then a prescription shipped at a cash price, with follow-up labs to confirm it works.
Sign up in a minute
Tell us your state, name and email. When care opens in your state, a quick eligibility check comes before you pay. Preval handles prescription lipid management only, and your clinician takes your health history at the visit.
A video visit, if it's a fit
A licensed clinician from our partner telehealth network meets with you by video, takes your history and checks that Preval is a good fit, following protocols written by a board-certified preventive cardiologist. If it isn't a fit, you get a full refund and advice on where to go instead.
Labs, or the results you already have
Your clinician orders advanced lipid testing at a lab near you, or works from recent results from Function Health, Superpower or your own doctor.
A prescription that fits you, at a cash price
Your clinician picks from oral enlicitide (Lipfendra), once-monthly lerodalcibep (Lerochol), or an injectable PCSK9 inhibitor taken every 2 to 4 weeks (Repatha or Praluent), based on your lipid profile and how you prefer to take it. We file no insurance claim, so you skip step therapy and prior authorization. Care costs $99 a month, and you see the medicine price before anything ships. Twice-yearly inclisiran (Leqvio) is given in person, and we are working with infusion centers to offer it.
Follow-up labs and dose adjustment
Your clinician repeats testing on a schedule that fits the medication and adjusts the dose or medicine to your results.
Cash pay is built for
- People who would rather not wait on a multi-week prior authorization for a medication they already know they need
- Anyone currently uninsured or between plans
- High-deductible plans where the insurance price and the cash price end up close anyway
- Needle-averse patients interested specifically in the oral option, Lipfendra
- People who want fewer injections and would rather take a once-monthly shot, Lerochol, than one every two weeks
Is Preval right for you?
Who Preval is for
Preval is a prescription cholesterol practice. See if it fits before you join.
A good fit
- Adults who want their LDL cholesterol (LDL-C) and ApoB lowered with prescription medicine and evidence-based targets
- People who can't or won't take a statin and are open to non-statin prescriptions (see statin intolerance)
- People who want faster access through cash pay, for example to a once-monthly PCSK9 inhibitor, including people their insurer turned down
- People who want labs every quarter and someone adjusting the plan so they reach their goal and stay there
Probably not a fit
- People who want to use only diet, exercise or supplements instead of prescription medicine
- Anyone who needs urgent or emergency care. If you have chest pain or other emergency symptoms, call 911.
- People with heart disease who need a cardiologist in person for symptoms or procedures. Preval works alongside your doctors and can't stand in for that care.
- People who mainly want a broad wellness lab panel without treatment (see Function Health alternatives)
Common questions
Is there a generic version of Repatha or Praluent I should look for instead?
No. Repatha (evolocumab) and Praluent (alirocumab) are biologic antibodies, and no generic or biosimilar version is available in the US as of now. The lower-cost options in the class are newer brand-name medicines: Lipfendra (oral enlicitide), a once-daily pill that launched in July 2026 at a list price of about $315 a month, and Lerochol (lerodalcibep), a once-monthly injection that LIB Therapeutics sells directly to patients for $199 a month.
How much does the oral PCSK9 inhibitor (Lipfendra) cost without insurance?
Merck launched Lipfendra in July 2026 at a list price of about $315 a month before any discount. We confirm your price before you commit, since it depends on the medicine and dose your clinician prescribes.
How much does Lerochol (once-monthly lerodalcibep) cost without insurance?
When it launched in the US on May 11, 2026, LIB Therapeutics announced a direct-to-patient cash price of $199 a month for Lerochol. Manufacturer cash programs can change, so we confirm the current price with you before you commit. Like other manufacturer cash purchases, it generally does not count toward an insurance deductible. Lerochol is a self-injection once a month and can be kept at room temperature for up to 3 months.
Can I use a manufacturer coupon or savings card with cash-pay access?
Manufacturer copay cards are generally built for people using insurance to fill at a retail pharmacy, so they typically do not apply the same way to a cash purchase. We tell you up front if a manufacturer or patient assistance program would save you more than the cash price.
Do I need a prescription, or can I just order the medication directly?
You need a prescription. A licensed clinician reviews your history first and orders labs if you need them, following protocols written by a board-certified preventive cardiologist. Cash pay changes how you pay for and receive the medicine, and the medical evaluation stays the same.
Does Preval bill my insurance?
Preval runs as a cash practice, so we don't bill insurance or file prior authorizations. Insurance-covered access can work well through your own doctor. Cash pay serves people who would rather not wait on prior authorization timelines, whose plan covers advanced lipid therapies poorly, whose insurer denied a PCSK9 inhibitor, or who are not currently insured.
Can I use a Repatha or Praluent card if I have Medicare?
Manufacturer copay cards generally cannot be used with Medicare or any federal insurance program, by law. Medicare Part D plans may still cover a PCSK9 inhibitor through their own approval process, so check with your plan before you choose.
Have PCSK9 inhibitors gotten any cheaper recently?
List prices have started to come down. Lipfendra launched at roughly half the list price of some injectable PCSK9 inhibitors, Lerochol launched with a $199-a-month direct cash program, and increased competition in the class has put some downward pressure on pricing overall. Insurance-negotiated and cash-pay prices can also be well below list price.
$99 a month, with medicines at cash prices.
We're rolling out cash-pay access slowly and taking a limited number of patients. Join the waitlist to get an early spot.
Join the Waitlist