Medicare and home IVs

[Keepercjr]

So I have seen a few messages stating that medicare won't pay for home IVs. I have medicare as primary and a PPO as secondary. For those of you with dual coverage, do you just not do home IVs anymore? I'm kind of freaked out about this. I haven't needed IVs in 6 years but I doubt this run will last forever. And I DO NOT want to be hospitalized. I have 2 young children. Also my CF center is 3 hours away which complicates things. We do have several local hospitals but they're not all that familiar with CF - and again, I just don't want to be hospitalized.

So would I have to suck up the 80% of my home IV bill that medicare won't pay? Is it that they won't pay for the medication or they won't pay for home nursing?

 

[Keepercjr]

So I have seen a few messages stating that medicare won't pay for home IVs. I have medicare as primary and a PPO as secondary. For those of you with dual coverage, do you just not do home IVs anymore? I'm kind of freaked out about this. I haven't needed IVs in 6 years but I doubt this run will last forever. And I DO NOT want to be hospitalized. I have 2 young children. Also my CF center is 3 hours away which complicates things. We do have several local hospitals but they're not all that familiar with CF - and again, I just don't want to be hospitalized.

So would I have to suck up the 80% of my home IV bill that medicare won't pay? Is it that they won't pay for the medication or they won't pay for home nursing?

 

[Keepercjr]

So I have seen a few messages stating that medicare won't pay for home IVs. I have medicare as primary and a PPO as secondary. For those of you with dual coverage, do you just not do home IVs anymore? I'm kind of freaked out about this. I haven't needed IVs in 6 years but I doubt this run will last forever. And I DO NOT want to be hospitalized. I have 2 young children. Also my CF center is 3 hours away which complicates things. We do have several local hospitals but they're not all that familiar with CF - and again, I just don't want to be hospitalized.
<br />
<br />So would I have to suck up the 80% of my home IV bill that medicare won't pay? Is it that they won't pay for the medication or they won't pay for home nursing?

 

[ej0820]

I am so glad you posted this. I was actually about to ask this after reading a few replies in Lauren's post about whether or not to accept medicare. I've got an IV session in the works for this coming week and my doc wants to send me home on IVs; one, so I can come home quicker, and two, because there aren't a whole lot of empty beds right now at my CF center.

If medicare doesn't cover home IVs, I'm in trouble. Freakin' medicare...

 

[ej0820]

I am so glad you posted this. I was actually about to ask this after reading a few replies in Lauren's post about whether or not to accept medicare. I've got an IV session in the works for this coming week and my doc wants to send me home on IVs; one, so I can come home quicker, and two, because there aren't a whole lot of empty beds right now at my CF center.

If medicare doesn't cover home IVs, I'm in trouble. Freakin' medicare...

 

[ej0820]

I am so glad you posted this. I was actually about to ask this after reading a few replies in Lauren's post about whether or not to accept medicare. I've got an IV session in the works for this coming week and my doc wants to send me home on IVs; one, so I can come home quicker, and two, because there aren't a whole lot of empty beds right now at my CF center.
<br />
<br />If medicare doesn't cover home IVs, I'm in trouble. Freakin' medicare...

 

[Giggles]

Yeah it sucks Medicare does not pick up homehealthcare but I still do it cause I can not STAND the hospital. However, I did luck out and I am not 100% sure how someone else can see if your homehealthcare company will do this but the one I used last time did not bill me for the balance that primary did not cover since Medicare they would not bill for me. TOTALLY confusing but I made out with only a few hundred dollars for homehealthcare verses another homehealthcare plan use to bill me close to $500 because Medicare was not covering it.

I guess all in all you can try to see if your homehealthcare company bills medicare for you and then see if they bill you balances. Also, it might be totally different when Medicare is primary cause in my case it is secondary which I was told makes a difference in terms of billing.

Confusing and totally stinks that Medicare rather pay on average $10,000 a day for us to be in hopsital when they could pay a fraction of that for homehealthcare! UGH!!!

But to answer your question I still do home IV's!

Good luck and feel better!
Breathe Easy
jennifer 38 with CF and CFRD

 

[Giggles]

Yeah it sucks Medicare does not pick up homehealthcare but I still do it cause I can not STAND the hospital. However, I did luck out and I am not 100% sure how someone else can see if your homehealthcare company will do this but the one I used last time did not bill me for the balance that primary did not cover since Medicare they would not bill for me. TOTALLY confusing but I made out with only a few hundred dollars for homehealthcare verses another homehealthcare plan use to bill me close to $500 because Medicare was not covering it.

I guess all in all you can try to see if your homehealthcare company bills medicare for you and then see if they bill you balances. Also, it might be totally different when Medicare is primary cause in my case it is secondary which I was told makes a difference in terms of billing.

Confusing and totally stinks that Medicare rather pay on average $10,000 a day for us to be in hopsital when they could pay a fraction of that for homehealthcare! UGH!!!

But to answer your question I still do home IV's!

Good luck and feel better!
Breathe Easy
jennifer 38 with CF and CFRD

 

[Giggles]

Yeah it sucks Medicare does not pick up homehealthcare but I still do it cause I can not STAND the hospital. However, I did luck out and I am not 100% sure how someone else can see if your homehealthcare company will do this but the one I used last time did not bill me for the balance that primary did not cover since Medicare they would not bill for me. TOTALLY confusing but I made out with only a few hundred dollars for homehealthcare verses another homehealthcare plan use to bill me close to $500 because Medicare was not covering it.
<br />
<br />I guess all in all you can try to see if your homehealthcare company bills medicare for you and then see if they bill you balances. Also, it might be totally different when Medicare is primary cause in my case it is secondary which I was told makes a difference in terms of billing.
<br />
<br />Confusing and totally stinks that Medicare rather pay on average $10,000 a day for us to be in hopsital when they could pay a fraction of that for homehealthcare! UGH!!!
<br />
<br />But to answer your question I still do home IV's!
<br />
<br />Good luck and feel better!
<br />Breathe Easy
<br />jennifer 38 with CF and CFRD

 

[JustDucky]

I have Medicare as my primary, no they don't cover home IV"s....ridiculous yes. I have managed to do some home IV's this way though, through my part D insurance (prescription). I had my doctor pre order the most commonly prescribed antibiotics (generic, I would never be able to afford brand name) and IV's to mix them in. As a result, I now have some antibiotics at home, granted, not all of what I am on is covered, so if I grow out a bug that is not sensitive to the antibiotics that I have at home, I have to either go in or do it as an outpatient at my local hospital. As a general rule of thumb, anything more than twice a day, I just go inpatient. It is just too exhausting to go back and forth any more than that.
I am currently in the hospital getting several IV's for my PA, I need to be here for sure, but now I have to be here for the whole course which could easily be 3 weeks all because my part D insurance does not cover Merrem or Imipenem.....
If you have other insurance besides Medicare, I would think you are covered at least partially for home IV's...most private insurance companies cover them as it makes sense and is cost effective. But if you are like me, and only have Medicare, Medigap and part D insurance, you have to get really creative and plan ahead if you want to do any IV's home.

Good luck,
Jenn

 

[JustDucky]

I have Medicare as my primary, no they don't cover home IV"s....ridiculous yes. I have managed to do some home IV's this way though, through my part D insurance (prescription). I had my doctor pre order the most commonly prescribed antibiotics (generic, I would never be able to afford brand name) and IV's to mix them in. As a result, I now have some antibiotics at home, granted, not all of what I am on is covered, so if I grow out a bug that is not sensitive to the antibiotics that I have at home, I have to either go in or do it as an outpatient at my local hospital. As a general rule of thumb, anything more than twice a day, I just go inpatient. It is just too exhausting to go back and forth any more than that.
I am currently in the hospital getting several IV's for my PA, I need to be here for sure, but now I have to be here for the whole course which could easily be 3 weeks all because my part D insurance does not cover Merrem or Imipenem.....
If you have other insurance besides Medicare, I would think you are covered at least partially for home IV's...most private insurance companies cover them as it makes sense and is cost effective. But if you are like me, and only have Medicare, Medigap and part D insurance, you have to get really creative and plan ahead if you want to do any IV's home.

Good luck,
Jenn

 

[JustDucky]

I have Medicare as my primary, no they don't cover home IV"s....ridiculous yes. I have managed to do some home IV's this way though, through my part D insurance (prescription). I had my doctor pre order the most commonly prescribed antibiotics (generic, I would never be able to afford brand name) and IV's to mix them in. As a result, I now have some antibiotics at home, granted, not all of what I am on is covered, so if I grow out a bug that is not sensitive to the antibiotics that I have at home, I have to either go in or do it as an outpatient at my local hospital. As a general rule of thumb, anything more than twice a day, I just go inpatient. It is just too exhausting to go back and forth any more than that.
<br />I am currently in the hospital getting several IV's for my PA, I need to be here for sure, but now I have to be here for the whole course which could easily be 3 weeks all because my part D insurance does not cover Merrem or Imipenem.....
<br />If you have other insurance besides Medicare, I would think you are covered at least partially for home IV's...most private insurance companies cover them as it makes sense and is cost effective. But if you are like me, and only have Medicare, Medigap and part D insurance, you have to get really creative and plan ahead if you want to do any IV's home.
<br />
<br />Good luck,
<br />Jenn

 

[Landy]

You may be referring to my reply to Loulou. I should have said that Medicare would not pay one penny towards the IV meds. My primary ins paid 80% on meds, but Medicare would not help with the remaining 20%, which was $1000. so I have to pay that. Sure makes me ??? doing home IVs in the future...

I have not been billed for the home health nurse portion yet & IVs were in April, so possibly they did pick up the co-pays on the home health care portion of it?

 

[Landy]

You may be referring to my reply to Loulou. I should have said that Medicare would not pay one penny towards the IV meds. My primary ins paid 80% on meds, but Medicare would not help with the remaining 20%, which was $1000. so I have to pay that. Sure makes me ??? doing home IVs in the future...

I have not been billed for the home health nurse portion yet & IVs were in April, so possibly they did pick up the co-pays on the home health care portion of it?

 

[Landy]

You may be referring to my reply to Loulou. I should have said that Medicare would not pay one penny towards the IV meds. My primary ins paid 80% on meds, but Medicare would not help with the remaining 20%, which was $1000. so I have to pay that. Sure makes me ??? doing home IVs in the future...
<br />
<br />I have not been billed for the home health nurse portion yet & IVs were in April, so possibly they did pick up the co-pays on the home health care portion of it?

 

[Giggles]

Landy from my understanding Medicare is suppose to pick up nurse visits just not the IV drugs... So maybe they did pick that up for you?

What a shame Medicare just does not pick up Homehealth IV care


Jennifer 38 with CF and CFRD

 

[Giggles]

Landy from my understanding Medicare is suppose to pick up nurse visits just not the IV drugs... So maybe they did pick that up for you?

What a shame Medicare just does not pick up Homehealth IV care


Jennifer 38 with CF and CFRD

 

[Giggles]

Landy from my understanding Medicare is suppose to pick up nurse visits just not the IV drugs... So maybe they did pick that up for you?
<br />
<br />What a shame Medicare just does not pick up Homehealth IV care
<br />
<br />
<br />Jennifer 38 with CF and CFRD

 

[Landy]

Jennifer, I figured they must have paid for the nurses.

I agree on them not paying for the meds<img src="i/expressions/face-icon-small-mad.gif" border="0">. I'm sure we're saving 10s of thousands of $$ by doing IVs at home!

 

[Landy]

Jennifer, I figured they must have paid for the nurses.

I agree on them not paying for the meds<img src="i/expressions/face-icon-small-mad.gif" border="0">. I'm sure we're saving 10s of thousands of $$ by doing IVs at home!