Does Medicare Cover Hyalgan Injections?

Knee osteoarthritis is a common cause of joint pain and impaired mobility. If you have knee pain caused by osteoarthritis and conservative treatments haven't helped, injections to lubricate the joint could improve your symptoms. Hyalgan injections can help relieve the pain of knee osteoarthritis and improve joint mobility. In some cases, Medicare may even cover Hyalgan injections. 

Does Medicare Cover Hyalgan Injections?

Original Medicare may cover Hyalgan injections under Part B if your doctor believes it is the best treatment for your condition and the treatment is medically necessary. Medicare will not approve funding for Hyalgan injections for any other purpose than the FDA-approved use, which is the treatment of pain caused by knee osteoarthritis that doesn't improve adequately with conservative treatment. 

Does Medicare Advantage Cover Hyalgan Injections?

Medicare Advantage Plans are available through private companies approved by Medicare. Many Medicare Advantage insurers offer a wider range of benefits than Original Medicare. Like Original Medicare, your Medicare Advantage Plan may cover medically necessary treatment of knee osteoarthritis using Hyalgan injections. 

What Is the Cost of Hyalgan Injections?

Generally, you should expect to pay around $200 per Hyalgan injection without insurance coverage. Hyalgan injections are usually administered as a course of five weekly treatments, adding up to a total cost of around $1,000.

If you qualify for assistance with the cost of Hyalgan injections through Medicare, you'll generally pay 20% of the Medicare-approved amount and the Part B deductible. As of 2024, the Part B deductible is $240. Purchasing a separate Medigap policy can help you cover your financial obligations when having Medicare-funded treatment. 

What Are Hyalgan Injections?

Hyalgan injections contain hyaluronic acid, which occurs naturally in the synovial fluid that cushions the joints. Osteoarthritis can cause the synovial fluid to break down, reducing joint lubrication and increasing friction. It's not known exactly how Hyalgan injections reduce pain, but it's thought that they help replenish the synovial fluid to ease friction and improve shock absorption. 

Hyalgan injections are approved for the treatment of knee osteoarthritis, and the FDA has not approved it as a treatment for other joints so far. The treatment is generally suitable for people who have tried more conservative treatment options, such as physical therapy and painkillers, but have not achieved adequate pain relief. 

A physician administers Hyalgan injections by injecting Hylagan fluid directly into the knee joint. Generally, the treatment is given as a course of between three and five injections at weekly intervals. 

People receiving Hyalgan injections should avoid putting pressure on their knee joints for around 48 hours after each injection. Most people can expect reduced pain and improved mobility after three injections. How long it takes to see results depends on each person's overall health and disease severity, and the pain relief provided by Hyalgan injections can last up to 6 months. 

What Are the Potential Risks of Hyalgan Injections?

Some people experience soreness or swelling in the affected joint after a Hyalgan injection. This is not usually considered a cause for concern, and the symptoms should improve after a few days. Mild pain and swelling should not interfere with the overall success of the treatment. 

Hyalgan injections contain ingredients that may trigger allergic reactions. Before starting your treatment, you should inform your doctor if you've ever experienced an allergic reaction to similar hyaluronic acid preparations before. You should also seek medical advice if you are allergic to bird products because some of the ingredients are taken from rooster combs.