Tricare

hannahj1d

New member
Hi, I was wondering if anyone knew if tricare covers home iv's? I have had tricare for years and am only now wanting to try home iv's over hospitilization because of work and school commitments. Lately i've been having to pay much more than normal for visits and such and was wondering if home ivs would be cheaper?
 

Beccamom

New member
I don't know about home IVs, but you can request a case manager. If your CF team makes the request you get approved quickly. If you make a request they have 30 days to assign you. My case manager was excellent at helping me find out costs so that I could make informed decisions.


QUOTE=hannahj1d;958237]Hi, I was wondering if anyone knew if tricare covers home iv's? I have had tricare for years and am only now wanting to try home iv's over hospitilization because of work and school commitments. Lately i've been having to pay much more than normal for visits and such and was wondering if home ivs would be cheaper?[/QUOTE]
 

Liza

New member
Yes they do. Hannah, are you a retired dependent or A/D dependent? Either way, they are covered, but home health care is not. So all blood draws for levels will have to be done at the lab and if you have a port and need your needle changed and don't do it yourself, you'll have to go in to get it changed. As for cost... it depends on your status, A/D or retired. My daughter just finished up her first home IV after getting married (A/D AF now) and didn't have any problems. She has a case manager. She did home IV when she was in college (we are AF retired) and had no problems either. We had/have TriCare Prime, when you retire you have the option of paying extra for Prime or just going with Standard. If you have standard then you pay a larger % out of pocket than Prime. We also had/have a supplement so we didn't pay anything out of pocket because it's covered by our supplement. A/D, shouldn't have any out of pocket expenses though. Depending on your cf clinic, you may need to do a week in hospital to make sure your levels are good before being released on home IV though. I think my girls did a minimum of 5 days in, never were they able to start off on home IV.
I hope this helps some....
I just noticed you posted this 5 days ago. I hope you've had success.
 

hannahj1d

New member
Liza, my stepfather is currently in the national guard, I know we have tricare reserve select which I believe is standard rather than prime. I called tricare and all they could tell me was it was a case to case basis and i would need my doctor to send an authorization request of why it is more important for me to do them at home vs in the hospital. I have my appointment tomorrow to see if this works out, at the least i would not mind going in for a few days and visiting the hospital for blood draws/port changes as it is only about 20 minutes from home (but I can't leave for school - which does not make complete sense to me). Either way, I am hoping for success in this, my mom informed me as a child I did home iv's once, we also had tricare then but also carried another insurance so it wasn't a problem, now I only have tricare so I am hoping for the best. Thanks a lot for your answer it is most definitely the most detailed I have received from anyone thus far.
 

Liza

New member
Hi Hannah, I was looking at Tricare Reserve select and this is what I came across. I hope the site will allow this link to stay up. PM me if it's not here. It should be covered for you, provided you get the prior authorization. http://www.tricare.mil/CoveredServices/SeeWhatsCovered/HomeInfusionTherapy.aspx
I did a search for home infusion therapy in your section of Tricare. Just so you know, my daughter's were never denied home IV.
Your clinic nurse, or who ever handles getting authorization for home IV, should know what to do, fill out, say to get home IV approved by your insurance co. As for the not being able to leave to go to class you mentioned, it's an insurance thing. "If you're well enough to leave then hospital, why are you in the hospital" kinda thing. We asked once a few years ago... by few, I mean like 10 or so, haha. When we were stationed in Germany and my oldest was in the hospital, they allowed her to leave between hook ups to go to a horse show that was down the street and they allowed her to come home (30-45 min. away) for Thanksgiving dinner as long as we had her back in time for her next IV. They said "no one likes being cooped up for so long and it's good to get fresh air", she was in a Dutch hospital. I hope it all works in your favor. I hope I've been of some help and let me know if I can offer any other suggestions.
 

hannahj1d

New member
Hi Liza, Thank you so much for the link that you sent that really helped me understand it more. My appointment went smoother than expected, as crappy as I feel my FEV1 did not drop so they sent me home w/ steroids and an antibiotic with directions to take a few days off work, get in more treatments and call back in 2 weeks to see if I do need to go in. My social worker said that home ivs is definitely a possibility and shoiuldnt be a problem at all which is really exciting if i do need to be hospitalized. Speaking of leaving the hospital I guess it does make sense insurance wise, however I did go to Children's Mercy in Kansas City, MO for about 5 years and they allowed day passes, the same sort of idea that your daugther had, where i was released just after my first iv and had to be back in time for my next one (Usually 4-5 hour later). I have also cultured MRSA and been on isolation since I was 10, and I think the doctors there said that played into the fact if you got a day pass or not.
 
T

ToriMom

Guest
Hi Hannah!
I hope you start to feel better on the steroids and rest. We are active duty Air Force and have TriCare prime. My daughter has done at least four rounds of home IVs and we have had no issues with getting it covered by insurance. We have no other coverage for her. I do need to take her in for labs sometimes but that is NOTHING compared to being inpatient. She has done them for up to a month at home. If your doctor requests the home IVs they should be covered. Our doctor tries to keep our daughter home as much as possible. The last time I took her in we spent only two nights in the hospital and the time before that we just got the PICC and went home on the home IVs with zero inpatient time. The doctor's philosophy seems to be a huge factor as our CF doc at another clinic never allowed zero inpatient time. Let me know if you have more questions or PM me. I hope you are able to feel better soon one way or the other...

Michelle--mom to Victoria (12, CF, gtube, tap dance lover) and Trace (no CF, autistic, 16)
 

Liza

New member
Hannah, you are so very welcome! I'm glad to hear that your appointment went better than expected. That's always good to hear. I hope the oral treatment they gave you helps and you can stay out of the hospital. It's hard to cram in those extra treatments but try and get them in as best you can. I'm sure you hear that from your mom too, we can't help it :D. Here's to a great holiday and a year of good health ahead!
 
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