Monoclonal antibodies for the treatment of early Alzheimer’s disease
Medicare Coverage Information
Overview
Medicare provides coverage for certain monoclonal antibody treatments for patients with early-stage Alzheimer's disease. These innovative treatments may help slow cognitive decline and are subject to specific medical criteria and approval processes.
- Coverage applies specifically to FDA-approved monoclonal antibody treatments for early Alzheimer's
- Requires documented diagnosis of early-stage Alzheimer's disease
- Treatment must be administered in a clinical setting
- Requires prior authorization and physician documentation
- Covered under Medicare Part B for eligible beneficiaries
- Medicare Part B beneficiaries
- Patients with a confirmed early Alzheimer's diagnosis
- Patients meeting specific clinical criteria
- Individuals receiving treatment from Medicare-approved providers
- Typically covered at 80% after meeting Part B deductible
- Patient may be responsible for 20% coinsurance
- Actual out-of-pocket costs may vary by specific Medicare plan
- Only approved for patients with confirmed early-stage Alzheimer's
- Must be prescribed by a Medicare-approved neurologist or specialist
- Ongoing medical monitoring and documentation required
- Coverage subject to medical necessity determination
- Consult with your neurologist about monoclonal antibody treatment eligibility
- Verify specific coverage details with your Medicare plan
- Obtain comprehensive documentation from your healthcare provider
- Contact Medicare directly at 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- MedicareAlzheimer's treatmentmonoclonal antibodiesearly Alzheimer's coverageMedicare Part B
Related Coverage Topics
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