{"id":118840,"date":"2023-12-29T15:28:00","date_gmt":"2023-12-29T15:28:00","guid":{"rendered":"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/"},"modified":"2023-12-29T15:28:00","modified_gmt":"2023-12-29T15:28:00","slug":"is-tepezza-covered-by-insurance","status":"publish","type":"post","link":"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/","title":{"rendered":"Is Tepezza covered by insurance?"},"content":{"rendered":"<p>Tepezza is a relatively new medication approved by the FDA for the treatment of thyroid eye disease (TED). TED is a rare autoimmune condition that causes inflammation and swelling in the muscles and tissues around the eyes, resulting in symptoms such as eye bulging, redness, pain, and vision changes.<\/p>\n<p>One common question that many patients have about Tepezza is whether or not it is covered by insurance. The cost of Tepezza can be quite high, with the treatment regimen typically consisting of eight infusions over the course of several months. Given the potentially significant financial burden of this treatment, it is important for patients to understand their insurance coverage options.<\/p>\n<p>**Is Tepezza covered by insurance?**<\/p>\n<p>Yes, Tepezza is covered by most insurance plans, including Medicare and Medicaid. However, coverage may vary depending on the specific plan and provider. Patients should consult with their insurance company to determine their coverage and any potential out-of-pocket costs.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_62 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#What_are_the_different_types_of_insurance_coverage_for_Tepezza\" title=\"What are the different types of insurance coverage for Tepezza?\">What are the different types of insurance coverage for Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Does_Medicare_cover_Tepezza\" title=\"Does Medicare cover Tepezza?\">Does Medicare cover Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Does_Medicaid_cover_Tepezza\" title=\"Does Medicaid cover Tepezza?\">Does Medicaid cover Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Do_private_insurance_plans_cover_Tepezza\" title=\"Do private insurance plans cover Tepezza?\">Do private insurance plans cover Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Does_Tepezza_have_a_patient_assistance_program\" title=\"Does Tepezza have a patient assistance program?\">Does Tepezza have a patient assistance program?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Are_there_any_financial_assistance_programs_available_for_Tepezza\" title=\"Are there any financial assistance programs available for Tepezza?\">Are there any financial assistance programs available for Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#What_should_I_do_if_my_insurance_does_not_cover_Tepezza\" title=\"What should I do if my insurance does not cover Tepezza?\">What should I do if my insurance does not cover Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#How_much_does_Tepezza_cost_without_insurance\" title=\"How much does Tepezza cost without insurance?\">How much does Tepezza cost without insurance?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Will_my_insurance_cover_the_entire_cost_of_Tepezza\" title=\"Will my insurance cover the entire cost of Tepezza?\">Will my insurance cover the entire cost of Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Can_I_appeal_a_decision_by_my_insurance_company_to_not_cover_Tepezza\" title=\"Can I appeal a decision by my insurance company to not cover Tepezza?\">Can I appeal a decision by my insurance company to not cover Tepezza?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Are_there_any_restrictions_on_how_many_infusions_of_Tepezza_my_insurance_will_cover\" title=\"Are there any restrictions on how many infusions of Tepezza my insurance will cover?\">Are there any restrictions on how many infusions of Tepezza my insurance will cover?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Will_Tepezza_be_covered_by_insurance_for_off-label_use\" title=\"Will Tepezza be covered by insurance for off-label use?\">Will Tepezza be covered by insurance for off-label use?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#Can_I_switch_insurance_plans_to_one_that_covers_Tepezza\" title=\"Can I switch insurance plans to one that covers Tepezza?\">Can I switch insurance plans to one that covers Tepezza?<\/a><\/li><\/ul><\/nav><\/div>\n<h3><span class=\"ez-toc-section\" id=\"What_are_the_different_types_of_insurance_coverage_for_Tepezza\"><\/span>What are the different types of insurance coverage for Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>1. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Does_Medicare_cover_Tepezza\"><\/span>Does Medicare cover Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nYes, Medicare Part B covers Tepezza for eligible patients. However, patients may still be responsible for co-payments, deductibles, and any costs that exceed Medicare&#8217;s coverage limits.<\/p>\n<p>2. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Does_Medicaid_cover_Tepezza\"><\/span>Does Medicaid cover Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nMedicaid coverage varies by state, but many states do provide coverage for Tepezza for eligible patients. Patients should check with their state&#8217;s Medicaid agency for more information.<\/p>\n<p>3. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Do_private_insurance_plans_cover_Tepezza\"><\/span>Do private insurance plans cover Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nMost private insurance plans do cover Tepezza, but coverage may vary depending on the specific plan. Patients should contact their insurance provider for more information about their coverage options.<\/p>\n<p>4. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Does_Tepezza_have_a_patient_assistance_program\"><\/span>Does Tepezza have a patient assistance program?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nYes, the manufacturer of Tepezza offers a patient assistance program for eligible patients who cannot afford the medication. Patients should contact the manufacturer or their healthcare provider for more information.<\/p>\n<p>5. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Are_there_any_financial_assistance_programs_available_for_Tepezza\"><\/span>Are there any financial assistance programs available for Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nSome pharmaceutical companies offer financial assistance programs for Tepezza to help offset the cost for patients who are uninsured or underinsured. Patients should inquire with their healthcare provider or the medication manufacturer for more information.<\/p>\n<p>6. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"What_should_I_do_if_my_insurance_does_not_cover_Tepezza\"><\/span>What should I do if my insurance does not cover Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nIf your insurance does not cover Tepezza, you may still be able to access the medication through a patient assistance program or financial assistance program. Speak with your healthcare provider to explore your options.<\/p>\n<p>7. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"How_much_does_Tepezza_cost_without_insurance\"><\/span>How much does Tepezza cost without insurance?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nThe cost of Tepezza without insurance can be quite high, potentially thousands of dollars per infusion. Patients should explore patient assistance and financial assistance programs to help offset these costs.<\/p>\n<p>8. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Will_my_insurance_cover_the_entire_cost_of_Tepezza\"><\/span>Will my insurance cover the entire cost of Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nInsurance coverage for Tepezza may not necessarily cover the entire cost of the medication. Patients may still be responsible for co-payments, deductibles, or any costs that exceed their insurance coverage limits.<\/p>\n<p>9. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Can_I_appeal_a_decision_by_my_insurance_company_to_not_cover_Tepezza\"><\/span>Can I appeal a decision by my insurance company to not cover Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nYes, patients have the right to appeal a decision by their insurance company to not cover Tepezza. Patients should work with their healthcare provider and insurance company to navigate the appeals process.<\/p>\n<p>10. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Are_there_any_restrictions_on_how_many_infusions_of_Tepezza_my_insurance_will_cover\"><\/span>Are there any restrictions on how many infusions of Tepezza my insurance will cover?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nSome insurance plans may have restrictions on the number of infusions of Tepezza they will cover. Patients should review their insurance policy or contact their insurance provider for more information.<\/p>\n<p>11. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Will_Tepezza_be_covered_by_insurance_for_off-label_use\"><\/span>Will Tepezza be covered by insurance for off-label use?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nInsurance coverage for off-label use of Tepezza may vary. Patients should consult with their healthcare provider and insurance company to determine coverage options for off-label use of the medication.<\/p>\n<p>12. <\/p>\n<h3><span class=\"ez-toc-section\" id=\"Can_I_switch_insurance_plans_to_one_that_covers_Tepezza\"><\/span>Can I switch insurance plans to one that covers Tepezza?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\nPatients may consider switching insurance plans to one that covers Tepezza if their current plan does not. However, patients should carefully review the coverage options of any new plan before making a decision to switch.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tepezza is a relatively new medication approved by the FDA for the treatment of thyroid eye disease (TED). TED is a rare autoimmune condition that causes inflammation and swelling in the muscles and tissues around the eyes, resulting in symptoms such as eye bulging, redness, pain, and vision changes. One common question that many patients &#8230; <\/p>\n<p class=\"read-more-container\"><a title=\"Is Tepezza covered by insurance?\" class=\"read-more button\" href=\"https:\/\/namso-gen.co\/blog\/is-tepezza-covered-by-insurance\/#more-118840\">Read more<span class=\"screen-reader-text\">Is Tepezza covered by insurance?<\/span><\/a><\/p>\n","protected":false},"author":21,"featured_media":107420,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[86279],"tags":[],"class_list":["post-118840","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-learn","no-featured-image-padding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Is Tepezza covered by insurance?<\/title>\n<meta name=\"description\" content=\"Tepezza is a relatively new medication approved by the FDA for the treatment of thyroid eye disease (TED). 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