With the excitement generated since Rhopressa was approved by the U.S. Food and Drug Administration, many Medicare recipients are interested to know if this medication is covered by Medicare benefits.

Understanding Glaucoma
As defined by the Glaucoma Research Foundation, “glaucoma is a complex disease in which damage to the optic nerve leads to progressive, irreversible vision loss.” For the seniors, this disease ranks just behind age-related macular degeneration on the list of common causes of blindness. Those over 60 years old have a six times greater chance of a glaucoma diagnosis. Other risk factors include severe nearsightedness and hypertension.

The primary types of glaucoma are open-angle and angle-closure. In both cases, there is an increase of pressure in the eye, known as intraocular pressure. Open angle is the most common. This type is hereditary, so those with immediately family members who have had glaucoma are at a significantly greater risk than the general population.

Rhopressa for Glaucoma
Because the disease typically has a slow progression with no noticeable symptoms, it is critical to have regular eye exams. Routine eye exams are recommended annually or every two years between ages 55 and 64; annually or semiannually after age 65. Vision can be saved with early detection followed by effective treatment.

Recent glaucoma medications approved by the FDA in 2017 are eye drops with the brand names of Vyzulta and Rhopressa. The generic name for Rhopressa is Netarsudil.  These drops are intended to move the fluid out of the eye to aid in reducing the pressure in the eye. It is important to follow the doctor’s instructions on the dosage, but the application is typically once each evening. Potential side effects include discomfort, red or teary eyes, blurring, and staining of the cornea. Changes in vision and pain are more serious side effects that many people do not encounter.

Medicare Benefits for Rhopressa
Rhopressa is now included in the formulary for Medicare Part D plans. Part D prescription drug coverage is an optional benefit offered to all Medicare recipients. Enrollment requires joining a plan that is approved by Medicare. Choices include a Medicare Prescription Drug Plan (PDP) added to Original Medicare or a Medicare Advantage Plan that includes prescription drug coverage. Regardless of the option taken, recipients are required to live in the service area of the plan they join. Costs and specific drugs covered vary.

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