Many glaucoma patients continue to face challenges with prescription eye drop refills due to insurance limitations. Insurers often restrict the amount of medication dispensed and the frequency of refills, typically adhering to a 30-day or 90-day supply schedule. These policies can be problematic, especially when patients inadvertently use more drops than prescribed due to application errors, leading to premature depletion of their medication.

Advocacy efforts by the American Glaucoma Society (AGS) and the American Academy of Ophthalmology (AAO) have prompted Medicare to issue guidance allowing early refills at day 21 of a 30-day prescription. Enforcement of this policy varies, however, and some patients still encounter refill denials. Here are some ways to handle those situations.

What to Do If You’re Denied Refills

If you’re experiencing issues with obtaining timely refills for your glaucoma medications, you can take these steps:

• Track your usage. Monitor how long each bottle lasts and discuss any discrepancies with your pharmacist.
  
• Consult your pharmacist. They can provide information on your insurance’s refill policies and may assist in requesting exceptions.
  
• File a complaint. If necessary, contact your insurance provider directly. For Medicare Part D or supplemental plans, call 1-800-MEDICARE (1-800-633-4227) and state “drug problem” when prompted.
  
• Inform your eye doctor. Bring your insurance and prescription cards to appointments and discuss any issues with medication shortages. Your doctor may provide samples or request an exception from your insurer.

Financial Assistance Programs for Glaucoma Medications

For those without insurance or facing high out-of-pocket costs, several pharmaceutical companies offer Patient Assistance Programs (PAPs):

• AbbVie. Offers assistance for medications like Alphagan P®, Combigan®, Durysta™, and Lumigan®.
  
• Alcon. Provides support for Rhopressa®, Rocklatan®, and Simbrinza®.
  
• Bausch + Lomb. Assistance available for Istalol®, OptiPranolol®, Pilocarpine HCl, Timoptic®, and Vyzulta®.
  
• Merck. Programs for Cosopt®, Timoptic®, Timoptic XE®, and Trusopt®.
  
• Novartis. Support for Azopt®, Betoptic® S., and Travatan Z®.
  
• Pfizer. Assistance with Xalatan™ through Pfizer RxPathways.
  

Eligibility criteria vary, so consult with your eye care provider to determine which programs you may qualify for.

Additional Resources:

• EyeCare America. Provides free or low-cost eye exams and care through volunteer ophthalmologists.
  
• Prevent Blindness. Offers a comprehensive list of financial assistance programs for vision care.
  
• PAN Foundation. Assists with out-of-pocket costs for medications and offers transportation support for medical appointments.
  
• NeedyMeds. A resource for finding assistance programs for medications and healthcare costs.
  

Staying informed about your insurance coverage and available assistance programs is crucial in managing glaucoma effectively. Regular communication with your healthcare providers and proactive management of your prescriptions can help ensure continuous access to necessary medications.

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