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How much does Medicare cover for Tysabri infusions, and what are the out-of-pocket costs?

Medicare typically covers Tysabri infusions, but your specific costs depend on which parts of Medicare you have. With Medicare Part B, which covers outpatient infusion treatments, you'll generally be responsible for:

- Your annual Show Full Answer

How much does Medicare cover for Tysabri infusions, and what are the out-of-pocket costs?

Medicare typically covers Tysabri infusions, but your specific costs depend on which parts of Medicare you have. With Medicare Part B, which covers outpatient infusion treatments, you'll generally be responsible for:

- Your annual deductible
- 20% coinsurance after meeting the deductible
- Any costs related to the infusion center visit

If you have Medicare Part D for prescription drug coverage, it may help with some medication costs, though infused medications like Tysabri are usually covered under Part B instead.

Your out-of-pocket expenses can vary significantly based on whether you have supplemental coverage (Medigap) or a Medicare Advantage plan, which may reduce your coinsurance responsibilities.

Unfortunately, people using Medicare don't qualify for manufacturer copay assistance programs that are available to those with private insurance. However, some nonprofit organizations offer copay assistance foundations specifically for people with MS who have Medicare.

It's worth speaking with a social worker at your neurologist's office or the infusion center. They can help you understand your specific coverage and identify any available financial assistance programs that work with Medicare.

 AI-generated responses are not a substitute for medical advice. These services are not intended to diagnose, treat, or cure any condition or disease. Always ask your doctor about specific health concerns.

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