Monoclonal antibodies for the treatment of early Alzheimer’s disease
Medicare Part B (Medical insurance) may cover FDA-approved monoclonal antibodies for the treatment of Alzheimer’s disease, if you're eligible
Description
Medications that may slow or delay symptoms of Alzheimer’s disease, but they don’t cure or reverse the disease.
Coverage details
Medicare covers FDA-approved monoclonal antibodies (like Leqembi, generic name lecanemab) that target beta-amyloid plaques for the treatment of Alzheimer’s disease.
Medicare coverage of these monoclonal antibodies requires your health care provider to collect evidence about how well these drugs work for a qualifying study or registry. The information your provider collects will help answer treatment questions and describe how well the medication works for you. Talk to your provider to find out if monoclonal antibodies for the treatment of early Alzheimer’s disease are right for you.
Who's eligible
Your doctor or other health care provider must confirm you have beta-amyloid plaques consistent with Alzheimer’s disease, and they must diagnose you with one of the following:
- Mild cognitive impairment due to Alzheimer’s disease
- Mild dementia due to Alzheimer’s disease
If you don’t meet the Part B coverage criteria for an FDA-approved monoclonal antibody for the treatment of early Alzheimer’s disease, you might be able to get the medication covered through a Part D plan. Contact your plan for more information.
Costs
- For Part B-covered monoclonal antibodies, you pay 20% of the Medicare-approved amount after you meet the Part B deductible .
- You may need scans and tests before or during treatment that might add to your costs. Talk to your provider for more information.
Facility
The drug is given intravenously (through a vein) in a provider’s office or other outpatient setting.