Synvisc® Medicare Coverage

Synvisc®
Chemical name: Hylan G-F 20

Typical dosage: 16mg/2ml

Typical type: Injection1

Synvisc® is a medication typically used to treat osteoarthritis of the knee. It is available as an injection and is brand name only.

Synvisc 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.

Synvisc is injected once weekly for 3 weeks, for a total of 3 injections.

Synvisc contains the active ingredient hyaluronate, which lubricates and cushions the joint, reducing pain in the knee.

The major side effects of Synvisc include skin discoloration at injection site, bruising, swelling, stiffness and mild pain in or by the knee.

Does Medicare cover Synvisc?

Medicare Part B may cover Synvisc if your doctor deems it medically necessary to treat your knee pain due to osteoarthritis (OA) after other conventional therapies (such as nonsteroidal anti-inflammatory drugs) fail to treat your pain.

If you have a Medicare Advantage plan, your plan will cover qualified Synvisic 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 Synvisc with Medicare drug coverage1

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

If your Synvisc 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

Synvisc is not appropriate for patients who have knee joint infections or skin diseases at the site of injection.

If you receive a Synvisc injection, avoid activity for 48 hours (or as instructed by your doctor). Do not stand on your feet for over 1 hour at a time during the first 48 hours after getting this medication.

 

 

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.