Dexamethasone Ophthalmic Implant (Ozurdex) and Insert (Dextenza) (CPB 0795, reviewed 2026-10-05)
Summary
Aetna covers Ozurdex (dexamethasone intravitreal implant) for macular edema from branch or central retinal vein occlusion, non-infectious uveitis affecting the posterior segment of the eye, and diabetic macular edema. Aetna considers Ozurdex not medically necessary with ocular or periocular infections, advanced glaucoma, aphakic eyes with rupture of the posterior lens capsule, or a non-intact posterior lens capsule, and it considers many other uses experimental and investigational because evidence is insufficient. Dextenza (dexamethasone ophthalmic insert) is covered for ocular inflammation and pain following ophthalmic surgery and for ocular itching associated with allergic conjunctivitis after failure of listed topical treatments, and it is not medically necessary with active ocular infection.
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