Lacrisert for IFP
Defines Cigna coverage and medical necessity criteria for Lacrisert for treatment of moderate to severe dry eye conditions for members under the payer's administered plans.
New policy created establishing coverage criteria for Lacrisert with an effective date of 4/1/2025.
Coverage Criteria for Lacrisert
Medical necessity: FDA‑Approved Indication
Covered when ALL of the following are met
When coverage is available and medically necessary, approve for up to 1 year if the patient has tried artificial tears; dosage, frequency, duration, and site of care should be clinically appropriate and supported by evidence.
Receipt of sample product does not satisfy criteria.
Any use of Lacrisert other than the ocular conditions listed in this policy is considered experimental, investigational, or unproven and is not covered. This includes indications beyond the documented examples of conditions associated with moderate to severe dry eye; the policy will be updated if new published data become available.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.