Hyalgan® Medicare Coverage

Hyalgan is a prescription medication usually injected into the knee and should only be administered by an experienced healthcare provider who has appropriate training, experience and knowledge of proper injection technique.

Hyalgan is classified as a viscusupplement and contains the active ingredient Hyaluronate. Hyalgan is injected once weekly for 5 weeks for a total of 5 injections. Some patients may benefit with a total of 3 injections.

Hyalgan works as a lubricant and shock absorber in the joints to help the joints work properly.

The major side effects of Hyalgan include injection irritation, mild pain, stiffness or warmth in or by the knee, back pain and muscle pain.

Does Medicare cover Hyalgan?

Medicare Part B may cover Hyalgan if your doctor deems it medically necessary to treat your knee pain due to osteoarthritis (OA).

If you have a Medicare Advantage plan, your plan will cover qualified Hyalgan 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.

Or call 1-800-557-6059 1-800-557-6059 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 Hyalgan with Medicare drug coverage¹

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

If your Hyalgan 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 $233 per year in 2022.

Additional information

Hyalgan is used in patients with osteoarthritis of the knee who have pain that is not responding to non-medication treatment and simple pain medications like ibuprofen.

Avoid activity for 48 hours after receiving an Hyalgan injection (or as long as you have been advised by a doctor). Do not stand on your feet for more than 1 hour at a time during the first 48 hours after getting this drug.

You should call your doctor if you experience severe knee pain, knee swelling or irritation where the drug is used.

You may not be able to get Hyalgan if you have a current or recent knee joint infection or infection at the site of injection.

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.