Eylea® Medicare Coverage

Eylea®
Chemical name: Aflibercept

Typical dosage: 2mg/0.05ml

Typical type: Injection1

Eylea® is a medication typically used to treat macular degeneration due to age, macular swelling, diabetic macular swelling and diabetic retinopathy. Eylea is available as brand only and is an injection given into the eye.

Eylea is a prescription medication that contains the active ingredient Aflibercept. Eylea is an injection given into the eye every 4 weeks for the first 12 weeks, followed by one injection every 8 weeks.

Eylea should only be administered by an experienced healthcare provider who has appropriate training, experience and knowledge of proper injection technique.

Eylea binds to receptors in the eye and slows vision loss. Eylea is tolerated very well, however a common side effect is seeing floaters.

You cannot fill a prescription for Eylea at a retail pharmacy.

Does Medicare cover Eylea?

Medicare Part B may cover Eylea if your doctor deems it medically necessary to treat your age-related macular degeneration (AMD).

If you have a Medicare Advantage plan, your plan will cover qualified Eylea treatment that would be covered by Medicare Part B.

Many Medicare Advantage plans also include coverage for other prescription drugs that may not be covered by Original Medicare.

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Average costs for Eylea with Medicare drug coverage1

Medicare coverage for Eylea can vary. You should speak with your doctor and contact your Medicare plan carrier to learn more about how your Eylea treatment may be covered by your plan.

If your Eylea treatment is covered by Medicare Part B, you will typically be responsible for paying the Part B coinsurance or copayment (20 percent of the Medicare approved amount) after you meet the Part B deductible, which is $185 per year in 2019.

Additional information

This medication should be administered by a licensed healthcare provider in a healthcare facility.

If you are taking Eylea, use care when driving or doing other tasks that call for clear eyesight. Have your eye pressure checked by your doctor.

Eylea can increase the risk of health problems caused by blood clots, such as heart attack and stroke.

Immediately report any signs of infection of the eye if you receive this medication. Signs of infection include eye pain or redness, photophobia, and blurred vision.

Do not use Eylea if you are pregnant, because it can harm the unborn baby. Use birth control before starting this drug, during treatment and 3 months after your last dose.  

 

 

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.