People who have been impacted by Alzheimer’s disease can now enjoy more coverage with their Medicare plan. As of July 6th, 2023, the Alzheimer’s drug Leqembi was officially approved by the U.S. Food and Drug Administration (FDA), meaning it is now covered by Medicare plans. Here’s what you need to know about Leqembi and Medicare.
What is Leqembi?
Leqembi is a new drug that’s used to slow the progression of Alzheimer’s disease in patients with mild cognitive impairment or mild dementia.
Unfortunately, Leqembi is not a cure. But it is the first traditionally approved treatment that addresses the underlying causes of the disease and can even change the entire course of the disease for people in early stages of treatment.
Changes with Leqembi and Medicare
Because it now has FDA approval, Leqembi is now officially covered under Medicare.
Prior to FDA approval, the average annual cost of Leqembi treatments ran upwards of $26,500 per year. Now that Leqembi and Medicare work together, people with traditional Medicare coverage will pay only 20% of the cost. Those with Medicare Advantage plans will pay 20% up to the maximum out-of-pocket cost for even more savings.
Requirements for Leqembi coverage
If you’re interested in taking Leqembi to treat mild or early-stage Alzheimer’s, there are several requirements that members must meet for Leqembi to be covered under Medicare:
- You must be enrolled in Medicare.
- You must be diagnosed with mild cognitive impairment or mild Alzheimer’s disease with evidence of amyloid plague on the brain.
- You must work with a doctor who participates in a registry that collects tests you’ve taken as part of your diagnosis to note whether you’re on blood thinners and to document any side effects from Leqembi.
If you meet these requirements, your Leqembi prescription will be covered by your Medicare plan, helping you save thousands annually.
Learn more about Leqembi and Medicare coverage
If you’re unsure about Leqembi and Medicare coverage in general, or if you need some help determining how your current Medicare insurance works with Leqembi, please don’t hesitate to contact the experts at Health Benefits Associates. We’ll help you find the perfect plan and coverage options to suit your unique needs. Call one of our Medicare Advisors at 775-828-1216 today to get started!