Does Medicare Cover Orthovisc Injections?

Christian Worstell
In this article...
  • Does Medicare cover Orthovisc? Discover whether Orthovisc is covered by Medicare and Medicare Advantage Plans and how much Orthovisc costs without insurance.

Knee arthritis is a painful condition that can cause mobility problems. Many people with knee arthritis get relief from an injectable lubricant like Orthovisc. But does Medicare cover Orthovisc? Below, you can find out whether Original Medicare and Medicare Advantage cover Orthovisc. 

Does Medicare Cover Orthovisc Injections?

Original Medicare (Parts A and B) doesn't cover Orthovisc injections. Unfortunately, beneficiaries with Part D coverage through a private insurer aren't covered for Orthovisc injections either. However, Part D coverage may cover other alternative drugs to treat joint pain and lubricate the joints. Beneficiaries can consult their physicians to find a suitable treatment for their condition that qualifies for Part D coverage. 

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Does Medicare Advantage Cover Orthovisc Injections?

It is unlikely that a Medicare Advantage plan will cover Orthovisc injections. You can check your plan's medication formulary to see if your insurer covers Orthovisc injections. 

How Much Does a Shot of Orthovisc Cost?

If you want to use Orthovisc injections to treat your condition and your doctor agrees, you will need to fund your treatment out of pocket unless you have private health insurance that covers Orthovisc. 

The cost of Orthovisc injections will vary depending on which provider and doctor you use. Generally, you should expect to pay between $550 and $1,300 for three 2-milliliter shots.  

How Do Orthovisc Injections Work?

Orthovisc injections contain purified hyaluronan, a chemical that occurs naturally in the joints. Hyaluronan acts as a joint lubricant and reduces the impact of shocks on the joint, allowing optimal movement. Certain conditions, such as osteoarthritis, can reduce the amount of hyaluronan naturally present in the joints, causing and exacerbating joint pain. 

A licensed doctor can inject Orthovisc into the affected joint to replenish hyaluronan levels and improve pain and mobility. The treatment is generally recommended for people who haven't experienced adequate pain relief using painkillers and physical therapy. Clinical trials show that Orthovisc is an effective treatment for knee pain caused by osteoarthritis, and it can relieve pain for up to 6 months following treatment. You should avoid straining the knee joint for at least 48 hours after the injection.

What Are the Risks of Orthovisc Injections?

The most common side effects of Orthovisc injections are pain, aching and swelling around the injection site. Some people also develop a localized skin reaction, such as hives or an itchy rash. Generally, side effects are mild and resolve within a few days. If you develop severe or persistent side effects, you should seek prompt medical attention. You should tell your doctor beforehand if you have an infection or are pregnant or breastfeeding because Orthovisc may not be suitable for you. 

Another potential risk of using Orthovisc injections is an allergic reaction. You shouldn't use Orthovisc if you're allergic to bird products because it contains hyaluronan harvested from rooster combs. 

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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