Uncategorized, Vision Correction

At Pacific Eye Surgeons, we understand how important it is for you to access the care and treatments you need — and how changes to financial assistance programs can create stress and uncertainty. We are here to support you through these changes.

Beginning January 1, 2025, Good Days Funding for many retina and macular disease treatments will no longer be available for most patients.

  • New enrollments are no longer being accepted.
  • If you are currently enrolled, you may be responsible for outstanding balances.
  • Please do not skip your appointments — your eye health is too important. Instead, speak with your doctor about alternative treatment plans or financing options.

If you have any questions or concerns, we encourage you to call us at (805) 545-8100. Our team is ready to help you navigate your options.

Medications and CPT Codes Potentially Impacted

For your reference, the following medications may be affected:

  • Eylea: J0178
  • Eylea HD: J0177
  • Ozurdex: J7312
  • Syfovre: J2781
  • Vabysmo: J2777P
  • Izervay: J2782

Financial Resources Available to You

We want you to know that resources are available to help with treatment costs:

Financing Through Pacific Eye Surgeons

Pacific Eye Surgeons offers flexible financing options that allow you to spread payments over time in a way that fits your budget.

Learn More About Financing Options
Call – Talk to Our Team Directly

Assistance Programs from Other Organizations

Several independent foundations and pharmaceutical companies have created assistance programs in response to these changes:

1. Independent Co-pay Assistance Foundations

  • Patient Access Network (PAN) Foundation: Provides financial support for patients managing costs related to macular diseases and retinal vein occlusion. Available to patients with Medicare, Medicaid, or private insurance.
  • National Organization for Rare Disorders (NORD): Offers disease-specific financial aid, including help with medication costs and insurance premiums for conditions like retinal vein occlusion and uveitis.

2. Pharmaceutical Company Support Programs

  • Genentech’s Referral Service: While their Ophthalmology Co-pay Program serves commercially insured patients, they can refer Medicare patients to independent foundations for help with treatments like VABYSMO™.
  • Regeneron’s EYLEA4U® Financial Assistance Program: Eligible patients prescribed EYLEA® may pay as little as $0 per treatment, with financial support up to $20,000 per year.
  • AbbVie Patient Assistance Programs: Helps U.S. patients who meet certain criteria access medications at no cost.

3. Medicare’s Extra Help Program (Low-Income Subsidy)

  • Assists Medicare beneficiaries with limited income in paying for premiums, deductibles, and prescription medication costs. While focused on Part D plans, it can still significantly lower overall expenses.

Important Note for Medicare Patients

Manufacturer-sponsored co-pay programs generally do not apply to patients enrolled in federal or state healthcare programs like Medicare. If you have Medicare, focusing on independent foundations and federal assistance programs will give you the best chance for support.

What You Should Do Next

  • Check Your Eligibility: Review each program’s requirements carefully.
  • Apply Early: Many programs operate on a first-come, first-served basis, so early action is critical.
  • Talk to Your Doctor or a Financial Counselor: We are here to help guide you through this process.

We know these changes can feel overwhelming, but please remember you are not alone. At Pacific Eye Surgeons, we are committed to helping you continue receiving the care you need.

If you have any questions about your coverage, treatment options, or financial assistance programs, please call us at (805) 545-8100.
We’re ready to support you every step of the way.