Taliglucerase Alfa
Specialty Drug

Elelyso

Taliglucerase alfa is a man-made form of an enzyme that is missing in patients with Gaucher's disease. It is used to treat the symptoms of Gaucher's disease. It is not a cure. Compare enzyme replacement therapies.

Taliglucerase Alfa Medicare Coverage

Overview

Does Medicare cover Elelyso?

Maybe.
40% of Medicare Part D and Medicare Advantage plans cover this drug, so it's pretty much a toss-up.

How much is my Elelyso co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Deductible
Typical
Donut Hole
Post-Donut Hole
Co-Pay Range
$800 – $896
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$200 – $896
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$351 – $896
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$15 – $896
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Taliglucerase Alfa

Here are some ways that may lower the cost of your Elelyso prescription.

Patient Assistance Program
Receive your prescription at no charge if you are eligible.
Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.

Find Your Taliglucerase Alfa Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 1 vial of Elelyso 200 units

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $220
AARP MedicareComplete Plan 1 (HMO) $231
AARP MedicareComplete SecureHorizons (HMO) $213
AARP MedicareRx Preferred (PDP) $258
AARP MedicareRx Saver Plus (PDP) $201
Aetna Medicare Rx Saver (PDP)Lower price available $896
Cigna-HealthSpring Preferred (HMO)Lower price available $889
Cigna-HealthSpring Rx Secure (PDP)Lower price available $896
Cigna-HealthSpring Rx Secure-Extra (PDP)Lower price available $896
EnvisionRxPlus Silver (PDP)Lower price available $896
Express Scripts Medicare - Value (PDP)Lower price available $896
First Health Part D Value Plus (PDP)Lower price available $896
Humana Enhanced (PDP) $264
Humana Preferred Rx Plan (PDP) $200
Humana Walmart Rx Plan (PDP) $200
Kaiser Permanente Senior Advantage (HMO) $279
MedicareBlue Rx Standard (PDP)Lower price available $896
SilverScript Choice (PDP)Lower price available $896
Symphonix Value Rx (PDP)Lower price available $896
WellCare Classic (PDP)Lower price available $896
Don't see your Medicare plan above?

Find and configure your plan to see exact co-pay prices for your meds.

Taliglucerase Alfa Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Elelyso that may include:

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Elelyso typically on?

Tier 5

Medicare plans typically list Elelyso in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). If you encounter any issues, please let us know.
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