Explore coverage information and available support resources for patients prescribed LEQEMBI
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LEQEMBI IQLIK® (at-home injection)
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LEQEMBI infusion (IV)
Medicare Insurance
LEQEMBI IQLIK is considered for coverage under Medicare Part D
Maximum out-of-pocket amount
In 2027, the maximum patient out-of-pocket cost for covered Medicare Part D drugs is $2400.* Once this amount is reached, patients will pay $0 for the rest of the calendar year. The Medicare Part D coverage gap has been eliminated.
Medicare Prescription Payment Plan
Talk to your patients about self-enrolling in the Medicare Prescription Payment Plan through their insurance provider. This plan helps eligible Medicare Part D patients manage out-of-pocket costs by spreading payments over the calendar year (January to December). Visit Medicare.gov for more information.
*The out-of-pocket maximum adjusts annually. [For 2026, the OOP cost for Medicare Part D is $2,100.]
Commercial Insurance
LEQEMBI IQLIK is considered for coverage under the pharmacy benefit for commercial insurance plans
With the LEQEMBI Copay Assistance Program, eligible commercially insured patients may pay as little as $0 in out-of-pocket expenses for each LEQEMBI IQLIK prescription.*
Patients can enroll at www.iqlikcopayenroll.com
*Depending on the insurance
plan, a patient could have additional financial
responsibility for any amounts over Eisai’s maximum
liability. Annual limits apply. Patient must have
private, commercial health insurance that provides
coverage for LEQEMBI. The offer is not valid for
patients enrolled in state
and federal health care
programs, including Medicare, Medicaid, Medigap, VA,
DoD, and TRICARE. The offer is not valid for
uninsured or self-paying patients, or for LEQEMBI
treatments reimbursed in full by any third-party
payer. Please see full Terms and Conditions at EisaiPatientSupport.com/LEQEMBI
LEQEMBI IQLIK may be obtained from the LEQEMBI Specialty Pharmacy Network:
LEQEMBI IQLIK may be obtained from the LEQEMBI Specialty Pharmacy Network:
Dedicated Line: 1-888-310-1766
Fax:
1-877-542-2731
Dedicated Line: 1-866-266-8037
Fax:
1-888-570-4700
LEQEMBI IQLIK may also be obtained from certain hospital and integrated delivery network (IDN) specialty pharmacies that are not part of the LEQEMBI IQLIK Specialty Pharmacy Network
As part of their prescription fulfillment process, specialty pharmacies typically support:
- Determining patient-specific coverage and cost requirements based on individual insurance benefits
- Helping patients understand anticipated out-of-pocket costs and identify available financial support resources for eligible patients
Physicians are encouraged to speak with their pharmacy about what to expect around the coverage determination process.
Medicare Insurance
LEQEMBI infusion is considered for coverage under Medicare Part B
Medicare covers LEQEMBI infusions for patients diagnosed with Alzheimer’s disease participating in a CMS-approved registry under the National Coverage Determination for anti-amyloid Alzheimer’s disease treatments. For more information on qualifying registries, visit CMS.gov.
After meeting the annual Part B deductible, patients typically pay 20% coinsurance for the drug and administration costs. Patients with Medicare Supplement insurance or other secondary coverage may have reduced or eliminated out-of-pocket costs.
Commercial Insurance
LEQEMBI infusion is considered for coverage under the medical benefit for commercial insurance plans
With the LEQEMBI Copay Assistance Program, eligible commercially insured patients may pay as little as $0 in out-of-pocket expenses for each LEQEMBI Infusion prescription.*
Enroll in LEQEMBI Companion®
*Depending on the insurance
plan, a patient could have additional financial
responsibility for any amounts over Eisai’s maximum
liability. Annual limits apply. Patient must have
private, commercial health insurance that provides
coverage for LEQEMBI. The offer is not valid for
patients enrolled in state
and federal health care
programs, including Medicare, Medicaid, Medigap, VA,
DoD, and TRICARE. The offer is not valid for
uninsured or self-paying patients, or for LEQEMBI
treatments reimbursed in full by any third-party
payer. Please see full Terms and Conditions at EisaiPatientSupport.com/LEQEMBI
Understand the patient journey:
Diagnosis to Treatment Brochure
An overview of the steps involved from diagnosis through treatment with LEQEMBI (for eligible patients)
LEQEMBI Companion Patient Support Program
The LEQEMBI Companion program can offer patients information and resources to help them access LEQEMBI.
The support program can help with:
- Understanding insurance coverage and potential out-of-pocket costs
- Identifying financial support programs for eligible patients
- Locating an infusion center or specialty pharmacy
Eisai cannot guarantee payment of any claim. Coding, coverage, and reimbursement may vary significantly by payer, plan, patient, and setting of care. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims. For additional information, customers should consult with their payers for all relevant coding, reimbursement, and coverage requirements. It is the sole responsibility of the provider to select the proper code and ensure the accuracy of all claims used in seeking reimbursement. All services must be medically appropriate and properly supported in the patient medical record.