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does Medicare cover Synvisc injections

Does Medicare Cover Synvisc Injections?

Seniors have a higher chance of having osteoarthritis than younger people do. It’s just a part of aging for many.

Older people get osteoarthritis because the protective cartilage that cushions the edge of the bones wears down as we get older.

The good news, however, is there are a number of treatments to help those of us who osteoarthritis.

One solution is that’s popular are Synvisc injections. So a common question many people have is, “Does Medicare cover Synvisc Injections?”

In this article, we answer that question in clear, plain English. You will also find the average costs of Synvisc injections and other helpful info.

Does Medicare Cover Synvisc Injections?

The short answer is generally not. In most cases, Medicare will not cover the cost of Synvisc injections. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Synvisc injections.

Original Medicare (Medicare Part A and Part B) does not provide coverage for Synvisc injections. That is because the FDA has not yet approved treatments for interventional pain management such as Synvisc injections.

However, there are times when Medicare may pay for a Synvisc injection. However, for them to cover a Synvisc injection, it must be deemed medically necessary by your healthcare provider.

It may be considered medically necessary if you have tried other treatments to combat osteoarthritis but they were not successful.

If approved by Medicare, coverage for Synvisc injection will fall under Medicare Part B. Medicare Part B will reimburse for Synvisc-One and SYNVISC but, again, only if you meet the conditions above.

Medicare Advantage plans (Medicare Part C) also provides coverage for Synvisc injections as long as the exact requirements above are met. These plans must cover everything Original Medicare covers and many also provide some additional benefits. However, out-of-pocket costs will vary depending on the plan provided by the plan providers.

How Much Does Synvisc Injection Cost?

A single 6 millimeters of Synvisc-One cost $177.01. A full course of 6 millimeters Synvisc-One cost $1,062 (see below for more info on what a full course involves).

What Is A Synvisc Injection?

Synvisc is an injection that lubricates the knee joints. Synvisc is also known by its chemical name, Hylan G-F 20.

The medication contains an active ingredient known as hyaluronate. Hyaluronate lubricates and cushions joints, and as a result, it reduces the pain in the knees.

Like many other medications, Synvisc has its fair share of side effects. Major side effects that users may experience include bruising, swelling, discoloration of the skin in the injected area, stiffness, and mild pain in the knees or the area near it.

The treatment course for Synvisc involves one injection each week for three weeks. So, three injections total. Synvisc must only be administered by an experienced healthcare provider who has proper knowledge and experience in injecting medications.

What Are The Symptoms Of Osteoarthritis?

Symptoms of osteoarthritis include pain, stiffness, softness, swelling, and popping sounds of the joints.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover electric scooters?

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