DEXTENZA

Indicated For

ocular inflammation and pain following ophthalmic surgery, ocular itching associated with allergic conjunctivitis

About This Medication

# DEXTENZA Patient Assistance Program Patient Guide: How to Get DEXTENZA at Low or No Cost DEXTENZA (dexamethasone ophthalmic insert) is a prescription corticosteroid treatment inserted into the eye by your doctor to reduce **ocular inflammation and pain** after eye surgery or to treat **ocular itching** from allergic conjunctivitis in adults and children aged 2 and older.[3] The **DEXTENZA Patient Assistance Program** from Ocular Therapeutix, Inc. provides this medication **free of charge** to eligible uninsured patients with household income below 500% of the Federal Poverty Level (FPL).[1][2] ## About DEXTENZA DEXTENZA is a small, **bioerodible insert** (0.4 mg dexamethasone) placed in the lower punctum (tear duct) of your eye during an office visit.[3] It releases medication over 30 days for post-surgical inflammation and pain, or up to 30 days for allergic conjunctivitis itching. Common side effects include increased intraocular pressure (6-10%), anterior chamber inflammation (10%), reduced visual acuity (1-2%), and headache (1%).[3] It's not recommended for young children needing sedation for insertion.[3] Always discuss benefits and risks with your eye care provider. ## Who Qualifies? This program helps **U.S. residents** who: - Lack health insurance or drug coverage for DEXTENZA (including Medicare, Medicaid, Medicare Advantage, or commercial plans without DEXTENZA coverage).[1][2] - Have **annual household income <500% FPL**.[1][2] **Income Eligibility Breakdown** | Household Size | Max Annual Income (2026 est.) | |---------------|-------------------------------| | 1 | $75,300 | | 2 | $102,000 | | 3 | $128,600 | | 4 | $155,300 | | +1 person | +$26,600 | *Note: Figures based on 2026 projected FPL (500% of HHS guidelines); verify current FPL at ASPE.hhs.gov. Income includes all household sources. Program may adjust or end anytime.[1][2]* ## Insurance Requirements You must be **uninsured** or have **no prescription coverage for DEXTENZA**.[1][2] This includes: - No private/commercial insurance covering DEXTENZA. - Medicare Part D without DEXTENZA coverage. - Medicaid without coverage. A separate **Commercial Assurance Program** exists for commercially insured patients (not government insurance), covering up to provider cost (~$640/unit), but that's distinct from this free PAP.[3] Confirm your status; insured patients may not qualify here.[1][2] ## Step-by-Step Application Process 1. **Discuss with Your Prescriber**: Your eye doctor confirms medical need and starts the process. They provide a prescription for DEXTENZA 0.4 mg.[1] 2. **Enroll in OcuCare Program**: Visit **www.MyOcuCare.com** or call **(877) 286-2207** (Mon-Fri 8AM-6PM EST) to enroll electronically or get forms.[1][2][6] 3. **Complete Application**: Download from dextenza.com or MyOcuCare.com. Include: - Patient info (name, DOB, address, phone, income). - Prescriber details (NPI, address, phone, signature, attestation). - Prescription. - **Patient and physician signatures**.[1] 4. **Submit Early**: Fax to **1-855-518-7564** or submit online. **Must arrive at least 5 business days before insertion**.[1][2] 5. **Approval Notification**: If approved, you get mail notice; doctor gets fax. Free DEXTENZA ships to you or office.[1][2] Support: (877) 286-2207 or www.MyOcuCare.com.[1] ## Timeline and Delivery - **Submit**: ≥5 business days pre-insertion.[1][2] - **Processing**: Expect review soon after; watch mail/fax.[2] - **Delivery**: Ships to patient or physician office post-approval.[1][2] Plan ahead—delays risk procedure postponement.[1] ## If Denied or Alternatives Denials may occur due to income, insurance, incomplete docs, or late submission. Contact (877) 286-2207 for reasons and resubmit if eligible.[2] Alternatives: - **DEXTENZA Commercial Assurance** for commercial insurance (up to $640).[3] - **Manufacturer copay cards** or pharmacy discounts (check dextenza.com). - **Other PAPs** via rxassist.org or NeedyMeds.org.[5] - Generic dexamethasone drops (discuss with doctor; not bioerodible insert).[3] - No biosimilars listed.[program data] Ocular may change programs anytime.[1][2] ## Important Disclaimer This guide summarizes the DEXTENZA Patient Assistance Program based on available info (©2023 Ocular Therapeutix).[1][2] Eligibility not guaranteed; Ocular reserves rights to modify/discontinue.[1][2] Not medical/financial advice—consult prescriber, benefits manager. Verify details at www.MyOcuCare.com or (877) 286-2207. Income/FPL subject to annual updates. Program for U.S. residents only.

Program information last verified: March 30, 2026