OZURDEX

Indicated For

DME, uveitis, BRVO, CRVO

About This Medication

# OZURDEX® Savings Program Patient Guide: How to Get OZURDEX® at Low or No Cost OZURDEX® (dexamethasone intravitreal implant) is a prescription eye implant used to treat certain conditions like macular edema or uveitis, and AbbVie's **OZURDEX® Savings Program** helps **commercially insured patients** reduce their out-of-pocket costs to as little as $0, but it excludes Medicare, Medicaid, or government program participants[1][2][5]. This guide explains eligibility, application steps, and support options in simple terms to help you access this treatment affordably. ## About OZURDEX® and Why Assistance Matters **OZURDEX®** is an injectable implant placed in the eye by your doctor to release medication slowly over time, helping reduce swelling and inflammation from conditions such as retinal vein occlusion, diabetic macular edema, or noninfectious uveitis[1][2]. Without help, costs can be high due to copays, coinsurance, or deductibles. The **OZURDEX® Savings Program**, run by AbbVie (formerly Allergan), covers these costs up to a maximum limit for eligible patients, making treatment more accessible[1][5]. Note: This is a copay savings program, not free medication for uninsured patients—see AbbVie's myAbbVie Assist for that option[3]. ## Who Qualifies for the Program? Eligibility is straightforward but specific: - **Age**: 18 years or older[1]. - **Insurance**: Must have **commercial (private) insurance** covering OZURDEX®; **not valid** for Medicare, Medicaid, other federal/state programs, or plans reimbursing full costs[1][2][5]. - **No income limits**: Unlike free drug programs, this focuses on insurance type, not household income[1][3]. - **Treatment**: Must be for an FDA-approved use, confirmed by your doctor[1][5]. If uninsured or on government insurance, check AbbVie's **myAbbVie Assist** program, which provides free medicine to qualifying low-income or uninsured US residents[3][4]. ## Income Eligibility Breakdown This program **does not use income thresholds**—it's based on insurance. For reference, AbbVie's separate patient assistance program (myAbbVie Assist) uses **Federal Poverty Level (FPL)** guidelines, typically up to 400-500% FPL depending on the drug, but OZURDEX® details are not listed there[3][6]. | Household Size | Estimated FPL Threshold (myAbbVie Assist example, not OZURDEX® Savings) | Notes | |---------------|-------------------------------------------------------------|-------| | Individual | Up to ~$60,000 (400% FPL) | Varies by program; confirm directly[3] | | Couple | Up to ~$80,000 | For free medicine programs only | | Family of 3 | Up to ~$100,000 | Not applicable to savings program | | Family of 4 | Up to ~$120,000 | See AbbVie site for exacts[6] | **Key point**: Use the table for context on free programs; **OZURDEX® Savings** requires only commercial insurance[1]. ## Insurance Requirements - **Required**: Valid commercial prescription insurance[1][5]. - **Excluded**: Medicare (Parts A/B/D), Medicaid, VA, Tricare, or any government-funded plans[1][2]. - **Process**: Submit claims to your primary insurer first, then use the program as secondary coverage via BIN #601341[1][5][9]. - **Private indemnity/HMO**: Invalid if they cover 100% of costs[1]. If your insurance changes or you're unsure, your doctor's office can verify via the Allergan EyeCue® portal[5]. ## Step-by-Step Application Process The process is doctor-led—patients get a savings card or ID after enrollment[5][9]. 1. **Ask your doctor**: Discuss OZURDEX® and request enrollment in the **OZURDEX® Savings Program**. They complete the **Enrollment Form** and upload/fax to Allergan EyeCue® portal or 1-866-676-4069[5][9]. 2. **Eligibility check**: EyeCue® emails confirmation (approved/denied) with member ID if eligible[5]. 3. **Get treatment**: Your doctor administers OZURDEX®; note out-of-pocket cost beforehand[5]. 4. **Submit reimbursement**: Doctor logs into EyeCue®, initiates claim, uploads: - HCFA/CMS-1500 form - Explanation of Benefits (EOB) from insurer - **OZURDEX® Reimbursement Request Form** - Physician note with product code, patient-paid amount, FDA-approved diagnosis[1][5][7]. Fax alternative: 1-866-676-4069. Claims due within **365 days** (or 180 days per some forms)[1][7]. 5. **Pharmacy/Claims**: If applicable, use BIN #601341 as secondary payer[1][9]. 6. **Get help**: Call 1-866-OZURDEX (1-866-698-7339) or 1-800-364-4767 for issues[8][9]. Your role: Provide EOB to doctor and confirm insurance details. ## Timeline and Delivery - **Enrollment approval**: Email from EyeCue® shortly after submission[5]. - **Reimbursement**: 3 days (ACH electronic) or 2-4 weeks (check) after claim approval[7]. - **Claims processing**: IQVIA handles; confirmation email sent[5]. - **Delivery**: No shipped medicine—this reimburses your costs post-treatment. Funds go to doctor's office or pharmacy[1][5]. Expect quick eligibility but plan 2-4 weeks for full reimbursement[7]. ## Alternatives if Denied or Ineligible - **Insurance appeal**: Ask insurer to cover more. - **myAbbVie Assist**: Free OZURDEX® for uninsured/low-income (apply at abbvie.com; phone 1-800-222-6885)[3][4]. - **Other savings**: Check GoodRx or NeedyMeds for discounts. - **Biosimilars**: None listed currently[program details]. - **Reapply**: Fix issues (e.g., wrong insurance) and resubmit[5]. ## Important Disclaimer This guide is for informational purposes based on publicly available program details as of latest updates; terms can change—always verify at ozurdexsavingsprogram.com or abbvie.com[1][2]. Not medical/financial advice. Consult your doctor/insurer. Program excludes government insurance; max savings limits apply. AbbVie/IQVIA not liable for misuse. Word count: ~950.

Program information last verified: March 30, 2026