I'm sorry. $365.00 a month total.

Hi Scrubbs,
I already have Medicare part A and part B (Hospital coverage and Physician Coverage). I've had that since I was approved three years ago but I didn't get the Part D prescription coverage because I was using my husbands private insurance as primary for everything including my Infusions which had already been fully covered under my hubby's private insurance.

My Part A and Part B is less than $160 though so do I need to purchase a supplemental coverage with part B? If not then are you saying all I need to get is Part D prescription coverage??

That's where the confusion lies with me. Is the drug "Privigen" (my immunoglobulin) covered under prescription coverage Part D or Part A and B? I just don't know who I can talk to that will be able to answer all my questions and explain this to me.

I may be making this more confusing than it needs to be. I just need to find out what I can do to have all of my infusion costs paid for since that is the most expensive.

Whew!!!

I just read this post again and think I understand what you are saying a little more. Please correct me if I'm wrong.... I already have Part A and Part B. Since I have both of these, I should look into getting a Part B Supplemental AND Part D Prescription Coverage. I need to read more about the part B Supplemental to understand it more clearly. I'm just confused about Part A paying 80% of the infusion cost because the majority of the infusion cost is from the drug itself and Part A doesn't cover medication.

Shari, read this:

http://www.fffenterprises.com/Blogs/...-Globulin.aspx

I'll keep on looking to see if I can find an official Medicare site.

Read this, too. (Scroll down to the part about MG -- it says page 11 on the bottom right hand side -- but, NOTE that the published date on this is 2007 -- and rules may have changed.)

http://www.bioalliance.org/Downloads...alCoverage.pdf

Did a search on Medicare's "official" site -- NOTHING at all. They must think it is over our heads.

BUT, your doc's insurance people will probably know -- the coding and all.

Thanks for the info jana I should be receiving the publication from SS with info about the Supplemental Insurance Policies within the next couple of weeks. I'm also waiting to hear back from my Neuro's office with information they have found out.

Just going to take a deep breath to calm myself and ask for a lot of guidance from God to help me figure all this out.

As always, I welcome thoughts and advice from anyone who is in the same situation as I am or from anyone who just wants to give me their two cents

Thanks everyone

Immunoglobulin infusions are covered 100% through Medicare Part A and Part B. 80/20. It is considered a medical procedure.

Privigen, the injectible IG, is considered a drug and is covered under Part D.
I pay nothing for my infusions. If I were taking Privigen, my co-pay would be 26% of the drug cost with the Part D plan I chose.

Go to http://www.medicare.gov

Under find plans. Click on Compare drug and health plans.

Enter your zip code. Then click on Find Plans.

Click the circle Original Medicare an then click the circle below.I don't get any extra help. Ignore the boxes that pop up. Then click on Continue to Plan Results.

Start entering the drugs you are taking. when you type in Privigen, It will be the first to show up. Click on ad drug. A pop up will show up. Fill out the info asked for then click on Add Drug and Dosage.

It will bring you to another screen that will show your input for Privigen.

You can start putting in your other drugs and they will be added to your list.

That screen will also have information on the top right you should write down.
Drug list ID and password date.

After you enter all your drugs, click on my drug list is complete.

On the next screen click on a pharmacy, then click on Continue to plan results.

Click the first box. Prescription Drug Plans (with Original Medicare) and the continue to plan results.

That will take you to all the insurance companies and show you what your premiums would be under the plans they offer and what your annual drug cost will be.

They come up in the order that will be the cheapest for you.

It will show you $25.80 monthly premium, Annual Drug Deductible: $320 and your annual co-pay. About $4200.00. to $4500. a year. Ouch.

My advice, try to talk to your Dr. and have him get you on the infusions.

Even though there is not much differance between the list of providers for Privigen, There could be a big saving for other drugs you may be taking.

Like I said before, my Cellcept, Mestinon and Prednisone cost me $36.00 for a 3 month supply of all three and my premium is $69.00 a month.

1-800-MEDICARE. A Rep from Medicare will take you through the entire procces above once you go to:
www.medicare.gov

Tony

For anyone else on Medicare Part D, I just want to add that going through this proccess can save you money.

I chose a plan for this year with a $69.00 monthly premium. Last year with another provider, my premium was only $39.00 but the the cost of my drugs went down so much because I am saving a Lot of money on my co-pays.

Tony

Thanks for all your help Tony. I'm going to follow your instructions and go to the link you provided as soon as I can print your instructions.

I just have a couple more things to ask you...

1. I've always had my IG infused with an infusion pump, even now with Privigen so I'm not sure why Privigen is coming up as an injectible drug

What's the name of your IG Brand? I used Octogam for many years until it was recalled and my doctor switched me to another brand which I had a bad reaction to (I think GammaGaurd) He then switched me over to Privigen which is infused.

I've never tried the injectible IG (I think it's called subcataneous or something like that)

2. Secondly, why in the world don't these agents for insurance companies understand that IVIG is a medical procedure?!?!?!?! I kept telling the lady from Anthem what it was and she kept treating it like it was something that I do everyday such as swallowing a pill! Of course you don't have that answer.... I just wanted to vent!
But I guess she was reading what the computer told her about Privigen when she said that I would have to pay 33% for Privigen each time I received the infusion which is VERY EXPENSIVE and that's why I went into Panic Mode

3. Sounds like if I get the right supplemental insurance along with the right prescription drug plan along with the "correct" IG brand then my infusion costs (including the drug) will be fully covered and I won't have to pay that "out of this world" co pay for the drug right?

4. Are you going to a hospital or infusion center for your infusions or are you being infused at home by a home health care agency?

Thanks SO much for your help. I REALLY appreciate it!