Does Medicare Cover Restasis?

Christian Worstell
In this article...
  • Find out whether Medicare covers Restasis and how much you can expect to pay for the drug. Learn about how these prescription eye drops treat dry eye disease.

Research suggests that roughly half of all adults in the United States suffer from symptoms of dry eye disease, according to an article published in the Ophthalmology Times. The condition occurs when your natural tears aren't enough to properly lubricate and protect your eyes. Tear production often slows due to aging and medical conditions, and allergies and certain medications can worsen symptoms.

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People with dry eye disease are at an increased risk of eye infections and damage to the eyes that could pose a risk of vision loss. Fortunately, treatments can ease symptoms such as itching and redness and lower the likelihood of complications. Doctors frequently prescribe Restasis for the treatment of dry eye disease. Medicare often covers these prescription eye drops, making the cost of the drug more affordable.

Does Medicare Cover Restasis?

GoodRx reports that 34% of Medicare prescription drug plans surveyed cover Restasis as of October 2023. If you're enrolled in Original Medicare (Parts A and B), coverage falls under Medicare Part D. This portion of Medicare is optional. You must sign up for a plan through a third-party insurer to receive coverage for Restasis and other drugs.

What Does Restasis Do?

Restasis is an eye drop approved by the U.S. Food and Drug Administration (FDA) to treat dry eye disease that arises due to inflammation on the surface of the eyes known as the cornea. Typically, you administer the eye drop two times per day with doses at least 12 hours apart. The drug works by reducing inflammation. Over time, this allows the eye to begin producing more tears.

How Much Does Restasis Cost?

Allergan, the manufacturer of Restasis, reports that the retail price for a 30-day supply of Restasis is around $645 as of October 2023. Prices vary by geographic location and from pharmacy to pharmacy.

Is There a Generic for Restasis?

The generic name for Restasis is cyclosporine. The FDA approved cyclosporine for sale in the United States in 2022.

How Much Will I Pay for Restasis With Medicare Part D?

With Medicare Part D, you'll typically have to pay a copay or coinsurance for Restasis. How much you're responsible for paying depends on how your plan classifies the medication and what stage of coverage you're currently at.

Laws require Medicare drug plans to cover at least one treatment for common medical conditions like dry eye disease; however, plans have the ability to choose which treatments they'll pay for.

Because Restasis doesn't have a generic alternative, your plan will likely classify it as a Tier 3 or 4 drug. You usually pay a higher copay for drugs in these tiers than you do for Tier 1 and 2. Copay amounts for Restasis vary widely from plan to plan. 

Does Medicare Part C Cover Restasis?

Some Medicare Part C or Medicare Advantage Plans include prescription drug coverage. If your plan provides the benefit, you'll need to consult the plan's formulary to find out if Restasis is covered. You'll usually have to pay a copay or coinsurance for covered drugs under Medicare Advantage.

Is There a Substitute for Restasis?

Cequa is another brand name version of cyclosporine. The cost of Cequa may be more or less than Restasis, depending on your plan's formulary.

Can I Get Help Paying for Restasis?

If you have Medicare Part D, you may be able to get help paying for premiums, deductibles and copays through the Extra Help program. The program is available for married Medicare enrollees whose net worth is $33,240 or less and for single Medicare enrollees whose net worth is $16,660 in 2023. Allergan states that most people who qualify for the Extra Help program pay less than $10 per month for Restasis as of October 2021.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with 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

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