We're here to help you and your loved ones get approval for the FDA-Approved Alzheimer's treatment drug. Here are the steps we are honored to walk you through:
Step 1
Clinical Diagnosis
An appropriate clinical diagnosis must be made by a physician by doing the following:
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A short mental status test (e.g. MMSE, MoCA)
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A functional assessment of the patient's independence
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The following diagnoses are covered (currently):
Alzheimer's Disease with early onset
Alzheimer's disease with late onset
Alzheimer's disease, unspecified
Mild cognitive impairment, so stated
Step 2
Confirm Pathology
Amyloid protein involved in Alzheimer's disease collects between neurons in the brain. Medicare requires a confirmation of the pathology. Amyloid can be detected either the following ways:
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PET/CT Brain Scan for Amyloid
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Lumbar puncture lab study
Step 3
Approval and Financial Planning
Individuals with Original Medicare will pay the standard 20% coinsurance of the Medicare-approved amount for Leqembi once they meet their Part B deductible. Costs may be different for people with Medicare supplemental coverage (like a Medigap plan) or other secondary insurance, or those enrolled in a Medicare Advantage plan. Individuals should contact their plan for more specific cost information.
Our most current quote for brain imaging is $6,490.80.
The drug, Lequembi, is expected to run ~$22,000/yr
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Currently, Medicare does not cover diagnostic testing.
Step 5
Administration
Lequembi is administered (per the Medicare approved dosage) through injection a maximum of every 14 days.
