Does Medicare Cover Beovu?

Most of the time, Original Medicare does not provide coverage for vision care. However, in some cases, Original Medicare will cover the costs of your vision treatment. Espe if it is medically necessary to treat your eye condition or if the condition affects your daily life.

For example, if you are experiencing age-related macular degeneration, or AMD, Beovu might be a good solution for you. Beovu is a brand-name injection for AMD that was approved by the FDA in 2019.

Now a question many considering this treatment have is, “does Medicare cover Beovu?”

In this article, we answer that question in clear, plain English. You will also find the average costs of Beovu injections if you have to pay for it out of pocket.

The short answer is yes; Medicare will cover the cost of Beovu. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your Beovu injections. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for Beovu injections if it is considered medically necessary. Your healthcare provider must first order the treatment for Original Medicare to provide coverage.

Beovu (brolucizumab) is a prescription medication that can treat wet, age-related macular degeneration. The FDA approved the drug for use in treating wet AMD in 2019. It is a treatment for the condition, but not a cure.

Coverage for Beovu usually falls under Medicare Part B. In this case, you will pay 20% of the cost of the prescription and Medicare will pick up the remaining 80%. The cost Medicare covers not just includes the prescription itself, but the cost of the health care provider that gives you the injection.

Original Medicare also provides coverage for other treatments for macular degeneration. Original Medicare provides coverage for your treatment for macular degeneration if it is considered medically necessary.

Coverage for treatment for macular degeneration is provided by Medicare Part B. Medicare Part B provides coverage for many treatments for macular degeneration.

One of the common treatments for macular degeneration is through injectable medications that go into the eye or blood. Medicare Part B provides coverage for injectable drugs like Eylea, Lucentis, Macugen, and others to treat wet macular degeneration.

Aside from the said macular degeneration injectable medications, Medicare Part B also provides coverage for the following types of treatment such as:

Avastin
Verteporfin
Aflibercept
Pegaptanib

Part C Coverage

Medicare Advantage plans (Medicare Part C) also provide coverage for Beovu injections. They cover everything Original Medicare covers (they have to!), plus some additional benefits.

However, exactly what a plan covers and how much the out-of-pocket costs are will vary depending on the plan you sign up for.

Unlike Original Medicare, Medicare Part C plans also may provide coverage for routine vision care, including purchasing eyeglasses and other vision services not covered by Original Medicare.

How Much Do Beovu Injections Cost?

The cost of a 6 mg/0.05 mL Beovu intravitreal solution is usually a little under $2,000 if you have to pay for it out of pocket. This cost is unlikely to vary much.

Beovu treatment typically is one injection in your eye each month for 3 months. Then an injection every 2 – 3 months after that.