Effective March 1, 2026, Cigna’s Individual and Family Plans (policy IP0721) clarify Lacrisert (hydroxypropyl cellulose ophthalmic insert) coverage for ocular conditions associated with moderate to severe dry eye. Approval is granted for up to 1 year when criteria are met, and a documented prior trial of artificial tears is required before authorization. The policy lists example covered conditions including decreased corneal sensitivity, exposure keratitis, keratoconjunctivitis sicca, and recurrent corneal erosions, aligning coverage with the FDA-labeled indication. The update references AAO 2024 guidance noting slow‑release hydroxypropyl cellulose inserts can be helpful for patients who cannot use artificial tears, supporting Lacrisert’s place in therapy.
March 2026 Revision: Lacrisert Coverage Scope and Approval Duration
This revision documents coverage specifics for Lacrisert (hydroxypropyl cellulose ophthalmic insert) under Cigna Individual and Family Plans, effective 2026-03-01, as reflected in policy number IP0721.
The policy highlights that approval for Lacrisert is for a duration of 1 year when criteria are met. The document emphasizes that Lacrisert is indicated for moderate to severe dry eye syndromes and related ocular conditions, and that prior use of artificial tears is an approval requirement.
FDA-Approved Indication and Examples of Covered Ocular Conditions
The policy affirms the FDA-approved indication: approval for Lacrisert for "Ocular Conditions Associated with Moderate to Severe Dry Eye." The coverage note specifies approval for 1 year if the patient has tried artificial tears. The policy enumerates example ocular conditions that fall under this indication, including decreased corneal sensitivity, dry eye syndrome, exposure keratitis, keratoconjunctivitis sicca, and recurrent corneal erosions.
These examples are presented as illustrative of the types of conditions for which Lacrisert may be used, aligning coverage to the labeled FDA indication for moderate to severe disease.
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