Ozurdex (Dexamethasone) Medicare Coverage

Ozurdex
Chemical name: Dexamethasone

Brand name: Ozurdex

Typical dosage: 5mg

Typical type: Tablet1

Ozurdex is a medication used to treat swelling of the eye. Ozurdex is only available as a brand-name drug and is typically administered by a health care professional.

Ozurdex is a medication containing the active ingredient Dexamethasone. Ozurdex is used in the eye to treat swelling of the eye due to surgery, inflammation or diabetic eye swelling. It is typically prescribed and administered by a doctor or other healthcare professional.

Ozurdex decreases swelling and inflammation by suppressing the production of inflammatory chemicals in the eye. It is an implant that is placed into the affected eye so the medication can continually be delivered to the area.

Common side effects of Ozurdex include blurry eyesight and feeling like something is stuck in the eye.

Does Medicare cover Ozurdex or Dexamethasone?

Ozurdex is not typically provided by retail pharmacies. Some Medicare Advantage plans and Medicare Part D plans in your area may cover treatment with Ozdurex when medically necessary.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Ozdurex.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Ozdurex with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Ozurdex is implanted by your doctor in a hospital or in another professional health care setting. Ozurdex is not to be used at home.

An Ozurdex implant constantly delivers medication to the eye. You do not have to remember to take a pill or think about the medication. Side effects are typically minimal.

It is normal to experience blurred eyesight after your doctor implants Ozurdex. Avoid driving and other activities that require clear eyesight until this goes away.

Certain eye problems have occurred in some patients while taking Ozurdex, including increased eye pressure, cataracts and glaucoma. Let your doctor know if you experience severe eye irritation or eye redness, or if bright lights start to bother your eyes or if you start to see floaters.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.