Does Medicare Cover Simbrinza?

In this article...
  • Simbrinza is a medication that can help people with glaucoma and high eye pressure. Read about available Medicare prescription drug coverage for this medicine.

People with glaucoma and other conditions that cause increased eye pressure may choose to use Simbrinza to help protect their eyesight. Simbrinza can be expensive since a lower-cost generic option isn't available at this time. 

However, many Medicare beneficiaries do have coverage for this medication. About 83% of Medicare prescription drug plans offer some coverage for Simbrinza. 

What Is Simbrinza?

Simbrinza is a prescription medication that's applied directly to the eyes in the form of eye drops. The medication lowers the pressure in the eyes caused by certain diseases, including glaucoma and ocular hypertension. Lowering eye pressure reduces the risk of complications, such as nerve damage, diminished vision and blindness. Simbrinza is made from a combination of the drugs brinzolamide and brimonidine.

Users are often advised to look up when placing the eye drops in the eyes and apply gentle pressure afterward. This helps keep the medication from dripping out of the eye. However, always follow your doctor's instructions when using Simbrinza or any other medication. 

How Much Does Simbrinza Cost With Medicare? 

The retail cost for Simbrinza is around $230, and no generic version is available. However, many Medicare plans do cover the medication.

The cost of Simbrinza with Medicare coverage can range from $6 to $219. The cost depends on the specific plan, required co-pays and whether the deductible has been met

Most Medicare plans classify Simbrinza as a tier 3 drug on their formularies. Drug tiers range from tier 1 to tier 5, and higher-tier drugs tend to cost more and have less coverage. Check your plan's formulary to find out more about available coverage. 

Are Discount Plans Available for Simbrinza? 

If your Medicare plan doesn't cover Simbrinza, discount plans or coupons may offer some help. Coupons are available and may reduce the cost of Simbrinza by up to 20%. 

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