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Old 06-30-2014, 03:44 PM #1
edwinlgreen edwinlgreen is offline
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Location: fleming island florida
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edwinlgreen edwinlgreen is offline
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Join Date: May 2013
Location: fleming island florida
Posts: 34
10 yr Member
Default Medicare for IVIG also Hospital for observation versus admitting

I posted this in my other tread but thought it might need its own tread so the comment line is seen.

I have plan F and would be in trouble with out it. It pays everything that medicare does not. costs about 190 dollars a month. i would be many thousands more in debt already this year with any other other plan. i have monthly ivig, have had a 5 day hospital stay plus more doctor visits by far in the last year and a half than in the previous 69 years all together.

Just a couple of warnings. Dont do in home IVIG. Medicare considers the medicine to be part of the treatment in a hospital or infusion center but part of the medicine covered by your drug policy if done in home. Doesnt make sense but my initial 5 treatment week would have cost over 1000 dollars with my drug plan copays in home.

If you do go to an emergency room don't let them keep you overnight for observation. Insist on being admitted. If you were to go into crisis, was kept overnight for observation, than it was determined you needed a short time in a rehab facility it could affect your coverage by medicare.

Medicare will only cover rehab after so many days in the hospital. I read where one patient was 'surprised' with a 30 thousand dollar bill because part of his hospital stay was considered 'for observation;' I have also read where some of our congress people are trying to get the rules changed so observation is considered the same as admitted but be aware.
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AnnieB3 (07-02-2014), Beamer (06-30-2014)

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Old 06-30-2014, 04:04 PM #2
uncledave uncledave is offline
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uncledave uncledave is offline
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THANK YOU for this information. I'm on Medicare myself and didn't know about this.
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Old 06-30-2014, 11:08 PM #3
Beamer Beamer is offline
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Beamer Beamer is offline
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I am new to medicare myself and not yet diagnosed with MG, still having tests done. I'm hoping it's chronic Lyme "masquerading " as MG as I have read it can do, but I do have leg weakness that began about 18 or more months ago. Most of the people in MG forums I've found are younger. As I'm new to medicare, it's important to learn the ropes or you could easily end up broke. I had heard that IVIG treatments are not covered unless you can get your primary doctor to document and write letters for you. Any input on that? Thanks for the information, it is most welcome.

Quote:
Originally Posted by edwinlgreen View Post
I posted this in my other tread but thought it might need its own tread so the comment line is seen.

I have plan F and would be in trouble with out it. It pays everything that medicare does not. costs about 190 dollars a month. i would be many thousands more in debt already this year with any other other plan. i have monthly ivig, have had a 5 day hospital stay plus more doctor visits by far in the last year and a half than in the previous 69 years all together.

Just a couple of warnings. Dont do in home IVIG. Medicare considers the medicine to be part of the treatment in a hospital or infusion center but part of the medicine covered by your drug policy if done in home. Doesnt make sense but my initial 5 treatment week would have cost over 1000 dollars with my drug plan copays in home.

If you do go to an emergency room don't let them keep you overnight for observation. Insist on being admitted. If you were to go into crisis, was kept overnight for observation, than it was determined you needed a short time in a rehab facility it could affect your coverage by medicare.

Medicare will only cover rehab after so many days in the hospital. I read where one patient was 'surprised' with a 30 thousand dollar bill because part of his hospital stay was considered 'for observation;' I have also read where some of our congress people are trying to get the rules changed so observation is considered the same as admitted but be aware.
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