Does Medicare cover Eylea injections?

Medicare usually covers costs of Eylea or Eylea HD after you meet your yearly Part B deductible. Then you will usually pay 20% of the Medicare-approved amount for the drug and any medical services. Your costs may vary depending on if you have insurance copays, coinsurance or administration fees.

Medicare (Part A and Part B) is the national medical insurance plan for people 65 years and older in the U.S. Medicare Advantage plans (Part C) include hospital coverage through Medicare Part A, medical insurance through Part B, and prescription drug coverage through Part D.

Call your Medicare plan to determine how Eylea or Eylea HD is covered under your insurance plan and what the alternatives are if it does not meet your needs.

Because Eylea is costly, your health insurance plan may require that you start treatment with less expensive therapies or may require a prior authorization. Contact your health insurance provider to determine their approved first-line treatments for your condition. Discuss any alternatives with your physician.

Be sure to speak with your doctor about medication costs before you start treatment, including costs to administer the medication and possible facility fees.

What if my Medicare plan does not cover Eylea?

If you are uninsured or do not have coverage for Eylea or Eylea HD, Regeneron Pharmaceuticals may be able to provide financial help through the Patient Assistance Program (PAP). Eligible patients may be able to get the medicine at no cost.

To qualify, you must be a resident of the U.S. (or its territories or possessions), be enrolled in the EYLEA4U program and show financial need with documentation. If you qualify, you may be eligible for assistance for up to one year of coverage of Eyela or Eylea HD.

To enroll in the EYLEA4U program, call 1-855-EYLEA4U (1-855-395-3248), and select option 4, Monday to Friday, 9 AM to 8 PM Eastern Time.

For people with commercial insurance (such as that provided by your employer), the Eylea Commercial Copay Card program may be an option to get the medicine for a $0 copay. The copay program is not valid for Eylea coverage under Medicaid, Medicare, Veterans Affairs, Department of Defense, TRICARE, or similar federal or state programs.

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What is Eylea used to treat?

Eylea (aflibercept) and Eylea HD are injectable eye medicines approved by the FDA to treat various retinal eye diseases. Eylea HD is given at a higher dose, has a longer duration of action and is not approved for all of the same uses as Eylea. They are not interchangeable (meaning they cannot be switched back and forth).

Eylea is used to treat:

• Wet age-related macular degeneration (Wet AMD)
• Diabetic retinopathy (DR)
• Diabetic macular edema (DME)
• Macular edema following retinal vein occlusion
• Retinopathy of prematurity

Eylea HD is used to treat:

• Wet age-related macular degeneration (Wet AMD)
• Diabetic retinopathy (DR)
• Diabetic macular edema (DME)

How does it work?

Eylea is a vascular endothelial growth factor (VEGF) inhibitor that helps to trap and block VEGF, a protein involved with blood vessel growth. By blocking VEGF, Eylea suppresses the growth of abnormal blood vessels and the potential for retinal fluid leakage, which can damage your retina.

Damage to your retina can lead to blurring of your vision and possible blindness.

How is it given?

It is given by intravitreal (inside the eye) injection after your healthcare provider numbs your eye. You may feel a small amount of pressure while you are receiving the injection but it should not be painful. Local injection into your eye will help to prevent side effects in other parts of your body.

Eylea is usually injected every 8 weeks in your doctor’s office or a clinic, but some patients may be able to have injections every 12 weeks after 1 year of treatment. Eyela HD injections may be given every 8 to 16 weeks, depending upon your condition. Your retina eye specialist will determine your dose and schedule.

This is not all the information you need to know about Eylea or Eylea HD for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.