Does Medicare Cover Zilretta?

About

Medicare 101

Current Clients

Does Medicare Cover Zilretta?

Senior black man standing up and experiencing knee pain stock image

By Daniel Petkevich

Nov 28, 2022

You've got coverage

No one should have to endure the pain of arthritis without appropriate treatment. For many Medicare beneficiaries, Zilretta is the best option to deal with the knee pain that comes with Osteoarthritis. Good news, Medicare offers coverage. But how are you covered? Let's find out.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

What is Osteoarthritis?

Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. It’s a degenerative joint disease that causes cartilage to thin and bones to rub together. Symptoms of OA can include the following:

Joint stiffness
Swelling
Pain
Decreased range of motion.

OA usually affects people over age 50, but it can occur at any age.

What is Zilretta and what are its benefits?

Zilretta (triamcinolone acetonide extended-release injectable suspension) is an FDA-approved nonsteroidal anti-inflammatory drug (NSAID) used to treat knee osteoarthritis pain. It works by slowly releasing the medicine into your joint, providing sustained pain relief for up to 12 weeks. Zilretta can be used as part of your OA treatment plan to reduce the need for opioid medications.

Does Medicare cover Zilretta?

Medicare Part B covers Zilretta when medically necessary and prescribed by a doctor. A doctor’s prescription is necessary because it must be administered by a qualified healthcare professional via injection. Medicare will cover 80 percent of the cost after you meet your Part B deductible. If you have a

Medicare Supplement Plan

, it may cover the remaining 20 percent. Talk to your doctor and insurance provider for more information on coverage and costs.

How to get Zilretta if you're covered by Medicare?

If you are covered by Medicare and have a prescription for Zilretta, you can get the medication from your pharmacy. Your doctor will need to provide your pharmacy with the information necessary to submit a claim to Medicare. Once approved, you may be asked to pay any applicable copays, coinsurance, or deductibles at the time of purchase. Your pharmacy may also offer payment plans to make it easier for you to get the medication you need.

It’s important to talk to your doctor and insurance provider about coverage and costs before starting any treatment plan. They can help you understand which treatments are covered by Medicare and if there are other options that might be right for you.

Takeaway

Medicare Part B covers Zilretta when prescribed by a doctor and medically necessary. Talk to your doctor and insurance provider about coverage and costs before starting any treatment plan. This content is for informational purposes only. If you have any questions about your Medicare plan, talk with an expert at

Fair Square Medicare

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

888-454-2383

info@fairsquaremedicare.com

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

•

Notice of Privacy Practices

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

Does Medicare Cover Zilretta?

You've got coverage

Speak with a Medicare Advocate

What is Osteoarthritis?

What is Zilretta and what are its benefits?

Does Medicare cover Zilretta?

How to get Zilretta if you're covered by Medicare?

Takeaway

Speak with a Medicare Advocate

Recommended Articles

More of our articles

Your Medicare One-Stop-Shop

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans