Good News! As of July 6, Medicare covers a new type of medication to treat Alzheimer’s disease more broadly. The Food and Drug Administration (FDA) gave traditional approval to the first drug of this kind, Leqembi (generic name lecanemab), for treatment in July 2023. While this drug may slow or delay symptoms of Alzheimer’s, it’s important to understand that it doesn’t cure or reverse Alzheimer’s disease.
People interested in Legembi should first talk with their provider to see whether this drug is right for them. It is given intravenously (through a vein) in a provider’s office or other outpatient setting.
To access Medicare’s coverage of this drug, you must:
- Be enrolled in Medicare
- Be diagnosed with mild cognitive impairment or mild Alzheimer’s disease dementia, with documented evidence of beta-amyloid plaque on the brain
- Have a physician who participates in a qualifying registry with an appropriate clinical team and follow-up care. This means your provider will submit data as part of an effort to understand how well this new medication works as part of your care. This is part of the process so Medicare will cover the drug.
Cost of New Alzheimer’s Drug
As Leqembi (generic name lecanemab), is covered by Medicare Part B, people with Original Medicare will pay the standard 20% coinsurance of the Medicare-approved amount for the medication after they meet the Part B deductible ($226 in 2023). If you have Medicare supplemental coverage (like a Medigap plan) or other secondary insurance, or if you’re enrolled in a Medicare Advantage plan, your costs may be different. Contact your plan for details about your coverage.
In addition to medication costs, you may need additional scans and tests before and/or during treatment that could add to your overall costs. Talk to your doctor about what scans and tests you may need as part of your treatment.
For more information, see the Center for Medicare and Medicaid Services’ press release: Broader Medicare Coverage of Leqembi Available Following FDA Traditional Approval.
