Does Medicare Cover Pazeo?

In this article...
  • Pazeo is a medication used to relieve allergic conjunctivitis symptoms. This article outlines whether Medicare Part D or Medicare Advantage covers Pazeo.

Seasonal allergies can cause various uncomfortable symptoms, which may include red, itchy eyes. If you're experiencing allergic conjunctivitis and other medications haven't worked, your healthcare provider may recommend a costly drug called Pazeo. 

Using Pazeo regularly can become expensive, so it's essential to plan how to pay for your medication. Below, you can find out whether Medicare enrollees have Pazeo coverage.

What Is Pazeo?

Pazeo is a type of topical antihistamine available on prescription to treat allergic conjunctivitis. This medication comes as a sterile eyedrop solution, and there is no generic version. It contains olopatadine, which is a mast cell stabilizer that prevents itching. 

Generally, doctors only prescribe Pazeo for adults. Most people apply one drop to each eye per day. This medication can cause side effects, which may include:

  • Blurred vision
  • Headaches
  • Stinging or dry eyes
  • Eye redness
  • Swelling

Does Medicare Cover Pazeo?

Generally, Medicare doesn't cover Pazeo, even if you have a Part D (prescription drug coverage) policy. You're also unlikely to have coverage if you're a Medicare Advantage enrollee with medication benefits. However, formularies (lists of covered drugs) vary between insurance providers, so it could still be worth checking in case your insurer is one of the few covering Pazeo. 

How Much Does Pazeo Cost With Medicare?

Most Medicare enrollees must purchase Pazeo out of pocket because it's rarely covered. Pazeo costs around $499.98 on average for five 4-milliliter eye droppers. However, you could get a significant discount by joining a medication voucher service. You could also consider comparing retail prices at a few pharmacies to find the best price. 

If your plan is one of the exceptions and covers Pazeo, you'll need to pay your yearly deductible before receiving coverage. After meeting your deductible, your insurer will likely charge a co-pay whenever it provides coverage for your prescription. The average co-pay for Pazeo is around $189.

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