For many Medicare beneficiaries looking for chronic gout treatment, Krystexxa (Pegloticase) can be a critical medication. If you have tried other forms of treatment for your gout with little success, Krystexxa can be a path to a more pain-free life. Krystexxa might be covered by Medicare Part D, and it will be covered by Medicare Part B. But which option saves you more money out-of-pocket? Let's dig deeper.
Krystexxa (Pegloticase) is an FDA-approved treatment for chronic gouty arthritis. It works by breaking down uric acid in the bloodstream, which can reduce inflammation and pain associated with gout. Krystexxa comes in a powder form that is dissolved in water and injected into muscles or under the skin. Other forms of treatment for gout include diet and lifestyle changes, medications such as allopurinol or colchicine, and joint injections of anesthetic or steroid medications. If these other options do not work for you, Krystexxa might be able to help.
Medicare Part B covers the cost of many drug therapies, including the cost of Krystexxa. If you have a Part D prescription drug plan, your plan might cover a portion or all of the cost for drugs like Krystexxa, depending on what is in your plan's formulary.
Medicare Part B covers the cost of Krystexxa, but you must meet certain criteria to be eligible for coverage. You must have a doctor's prescription for the drug and your doctor must specify that it is medically necessary, as well as provide documentation supporting their medical opinion. Your doctor also needs to certify that you tried other treatments.
If you're getting coverage for your Krystexxa on Part B, you might be responsible for 20% of the cost that Medicare does not cover. If you have a Medicare Supplement plan, that could cover some or all of that 20%. The average cost of could run as high as $60,000 per year, so that 20% could be as much as $12,000.
Medicare Part D might also cover a portion or all of the cost for drugs like Krystexxa. Contact your insurance plan provider to find out and ask if they cover Krystexxa in their formulary.
Krystexxa can cause side effects, including nausea, vomiting, abdominal pain and heartburn. Other possible side effects include anemia, elevated blood pressure, low white blood cell counts and allergic reactions such as itching or hives. It's important to talk to your doctor about any potential risks before starting treatment with Krystexxa.
It is important to find a doctor who understands how to use Krystexxa properly and will monitor your progress while you are using it. Ask your primary care provider if they know of any doctors in your area who specialize in gout treatment. You can also search online for physicians who specialize in gout treatment or contact the drug's manufacturer, Savient Pharmaceuticals, to find a doctor near you.
Living with gout can be difficult, but there are some things you can do to make it easier. Eating a healthy diet and exercising regularly can help reduce inflammation and pain associated with gout attacks. Drinking plenty of water helps flush through the uric acid crystals in your system that causes the pain. Avoiding or reducing processed foods, high-purine foods, and alcohol can help reduce the frequency of gout attacks. Lastly, talk to your doctor about other forms of treatment that might be more suitable for you.
In conclusion, Krystexxa (Pegloticase) is an important treatment option for those with chronic gouty arthritis who have not had success with other forms of treatment. Medicare Part B and Part D might cover some or all of the cost of your prescription. You should check in with your doctor to see if Krystexxa is right for you and your plan provider to see how you can receive coverage through Medicare. This content is for informational purposes only. If you have additional questions about your Medicare plan, call one of our experts today at 1-888-376-2028.

Does Medicare Cover Hepatitis C Treatment?
Nov 22, 2022

Does Medicare Cover Piqray?
Dec 2, 2022

13 Best Ways for Seniors to Stay Active in Columbus
Mar 8, 2023

14 Best Ways to Stay Active in Charlotte
Mar 9, 2023

Is Fair Square Medicare Legitimate?
Jul 27, 2023

Does Medicare Cover Cataract Surgery?
Dec 22, 2022

How Much Does Medicare Cost?
Jul 25, 2022

Does Your Plan Include A Free Gym Membership?
Jul 12, 2023

Does Medicare Cover TENS Units?
Nov 23, 2022

Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023

Does Medicare Cover Diabetic Eye Exams?
Jan 11, 2023

Does Medicare Cover Ketamine Infusion for Depression?
Nov 23, 2022

How Much Does Rexulti Cost with Medicare?
Jan 24, 2023

What to Do When Your Doctor Doesn't Take Medicare
Feb 24, 2023

Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022

Medicare Deductibles Resetting in 2025
Jan 18, 2024

Does Medicare Cover Fosamax?
Nov 30, 2022

Does Medicare Cover Light Therapy for Psoriasis?
Jan 17, 2023
13 Best Ways for Seniors to Stay Active in Philadelphia
14 Best Ways for Seniors to Stay Active in Nashville
14 Best Ways for Seniors to Stay Active in Seattle
2024 Cost of Living Adjustment
Building the Future of Senior Healthcare
Can I Choose Marketplace Coverage Instead of Medicare?
Can I Have Two Primary Care Physicians?
Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?
Can Medicare Help with the Cost of Tyrvaya?
Denied Coverage? What to Do When Your Carrier Says No
Do All Hospitals Accept Medicare Advantage Plans?
Do Medicare Supplement Plans Cover Dental and Vision?
Does Medicare Cover Bladder Sling Surgery?
Does Medicare Cover Boniva?
Does Medicare Cover Cala Trio?
Does Medicare Cover Cartiva Implants?
Does Medicare Cover Cold Laser Therapy (CLT)?
Does Medicare Cover Cosmetic Surgery?
Does Medicare Cover Disposable Underwear?
Does Medicare Cover Geri Chairs?
Does Medicare Cover Hearing Aids?
Does Medicare Cover Home Heart Monitors?
Does Medicare Cover Hypnotherapy?
Does Medicare Cover Inqovi?
Does Medicare Cover Inspire for Sleep Apnea?
Does Medicare Cover Medical Marijuana?
Does Medicare Cover Mental Health?
Does Medicare Cover Mouth Guards for Sleep Apnea?
Does Medicare Cover Orthodontic Care?
Does Medicare Cover Physicals & Blood Work?
Does Medicare Cover Robotic Surgery?
Does Medicare Cover Scleral Lenses?
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Does Medicare Cover SIBO Testing?
Does Medicare Cover the WATCHMAN Procedure?
Does Medicare Cover Urodynamic Testing?
Does Medicare Pay for Funeral Expenses?
Does Medicare Pay for Varicose Vein Treatment?
Does Your Medicare Plan Cover B12 Shots?
Explaining IRMAA on Medicare
Finding the Best Dental Plans for Seniors
How Do Medicare Agents Get Paid?
How Does Medicare Cover Colonoscopies?
How Does Medicare Pay for Emergency Room Visits?
How Much Does a Medicare Coach Cost?
How Much Does Trelegy Cost with Medicare?
How Much Does Xeljanz Cost with Medicare?
How to Choose a Medigap Plan
How to Compare Medigap Plans in 2025
How to Enroll in Social Security
Is HIFU Covered by Medicare?
Is Vitrectomy Surgery Covered by Medicare?
Medicare 101
Medicare Advantage MSA Plans
Medicare Advantage Plans for Disabled People Under 65
Medicare Consulting Services
Medicare Explained
Medicare Supplement Plans for Low-Income Seniors
Medigap Plan N vs. Plan G — Which One Fits You in 2025?
Plan G vs. Plan N
What is a Medicare Beneficiary Ombudsman?
What Is a Medicare Supplement SELECT Plan?
What is Plan J?
What is the 8-Minute Rule on Medicare?
What To Do If Your Medicare Advantage Plan Is Discontinued
What to Do When Your Doctor Leaves Your Network
What You Need to Know About Creditable Coverage
What's the Deal with Flex Cards?
What's the Difference Between HMO and PPO Plans?
Which Medigap Policies Provide Coverage for Long-Term Care?
Why You Should Keep Your Medigap Plan
Will Medicare Cover it?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
MULTIPLAN_FairSquareMedicare_01062022_M
Fair Square Medicare
