As of January 1, 2025, Good Days Funding for retina and macular disease is unavailable for many patients.
If you’re currently enrolled, you may be responsible for outstanding balances. New enrollments are not being accepted. Please do not skip your appointments — speak with your doctor about alternative treatments or financing options.
We understand this may be a stressful time, and we are committed to working with you.
For Your Reference: Drug Names and Associated CPT Codes Possibly Impacted
- Eylea: J0178
- Eylea HD: J0177
- Ozurdex: J7312
- Syfovre: J2781
- Vabysmo: J2777P
- Izervay: J2782
Resources Available For You
Shaaf Eye Center has several financing options available, allowing you to pay over time with flexible monthly payments that fit your budget. Click here to learn more about financing.
In response to this update, several pharmaceutical companies have also established their own patient assistance programs to help mitigate the financial impact. There are assistance programs specifically designed to help Medicare beneficiaries with their co-insurance and out-of-pocket expenses for retina injections. Please note, it’s advisable for patients to consult with their healthcare providers or the financial assistance departments of the respective pharmaceutical companies.
1. Independent Co-pay Assistance Foundations:
- Patient Access Network (PAN) Foundation: Offers assistance with co-payments related to treatments for macular diseases and retinal vein occlusion. Eligible patients with Medicare, Medicaid, or private insurance may receive support.
- National Organization for Rare Disorders (NORD): Provides disease-specific assistance programs for patients with retinal vein occlusion and uveitis, including help with medication costs and insurance premiums.
2. Pharmaceutical Company Programs:
- Genentech’s Referral Service: While Genentech’s Ophthalmology Co-pay Program is primarily for commercially insured patients, they offer referrals to independent co-pay assistance foundations for patients with public health insurance, such as Medicare. These foundations may help cover out-of-pocket costs for treatments like VABYSMO™ (faricimab-svoa).
- Regeneron Pharmaceuticals offers the EYLEA4U® Financial Assistance Program for patients prescribed EYLEA® (aflibercept) Injection. Eligible patients may pay as little as $0 per treatment, with assistance up to $20,000 per rolling year.
- AbbVie has patient assistance programs that supply certain products to patients in the U.S. who are unable to afford their medications and meet specific eligibility criteria.
3. Medicare’s Extra Help Program:
- Low-Income Subsidy (LIS) Program: Also known as Extra Help, this federal program assists Medicare beneficiaries with limited income and resources by covering premiums, deductibles, and co-payments related to prescription medications. While it primarily addresses Part D expenses, enrolling can significantly reduce overall medication costs.
Manufacturer sponsored co-pay assistance programs are generally not available to patients enrolled in federal or state healthcare programs, including Medicare. Therefore, exploring independent foundations and federal assistance programs would be the best option for Medicare patients.
Next Steps:
- Assess Eligibility: Review the specific eligibility criteria for each assistance program to determine qualification.
- Apply Promptly: Many programs have limited funding and operate on a first-come, first-served basis. Early application increases the likelihood of receiving assistance.
- Consult Healthcare Providers: Discuss these options with your healthcare provider or a financial counselor at your treatment center. They can offer guidance and may assist with the application process.
By exploring these avenues, Medicare beneficiaries can potentially alleviate the financial burden associated with retina injection treatments.
Contacts:
Good Days Funding: (877) 968-7233
Shaaf Eye Center: (760) 346-5005
