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edwinlgreen 11-14-2013 09:45 AM

Cost of IVIG
 
My Neuro is considering IVIG for me so he can reduce the level of prednisone. He has ordered blood tests to predict my ability to tolerate IVIG. My question is about the costs. One of my findings from research on the internet suggest the largest part of the costs is from the drugs. That makes me question if there is drug costs as well as a medical costs. I am in an open enrollment period for drug plans and can still change.

My medical is Aetna intergration Plan A to supplement Medicare. My company retirement plan changes 1/1 and it will no longer be available thru the company plan. I have signed up for AARP MedicareRx (Medicare plan F). Plan F looks to be my best choice but other providers are available. Has anyone had trouble getting IVIG coverage thru the AARP plan.

Has anyone had experience in this area. I can still change drug and medical plans at this time.

I tested positive on all 3 blood antibody tests last March after Ptosis, double vision and tunnel vision. Prednisone elimanated the vision issues but I still have muscle weakness and get very tired very quickly. The pred seemed to make these issues more severe. I started at 80 MG a day on the pred and have tapered to 20. Any input is welcome.

Juanitad 11-14-2013 04:12 PM

IVIG is paid under Medicare Part B - not the RX plan. I'm on Medicare with an AARP supplement plan and I don't pay any of the IVIG costs. I also have the AARP Rx plan and the infusion center doesn't file with them at ll.

Southern Bell 11-15-2013 10:29 AM

I have had several rounds of IVIG - two while in the hospital and three at home. These were done while I was on my private BCBS insurance. The insurance company paid the total cost for each (which I believe the cost for each is about $25,000). Since I had no positive results from IVIG I didn't pursue it. I'm not sure about Medicare coverage. I would think that if Medicare approves the procedure under Part B your supplemental insurance will cover their portion of the remaining cost. The facility that would be doing the procedure may be able to help you with your concerns.

Southern Bell
:grouphug:

davew41 11-23-2013 11:10 AM

Ivig is not cheap. I was on it 2 times a month for just over a year Neuro kept telling me to go. Never did get anything out of it we except a few jiffy headaches. Got to a new neuro that had access to 3,4 dap and we are trying that.

cait24 11-24-2013 07:52 PM

First round of IVIG made me very sick and I was worse than when I started. The second round did improve my breathing issues and leg strength and I am good on 60 mg X 4 of mestinon instead of 120 X 4.

But it did not make me whole or my pre-MG self. I think I will only take it when my breathing gets bad like this time.


kathie

edwinlgreen 12-05-2013 11:30 AM

Update. My Neurologist recommended home infusion, 5 day treatment followed by once a month. The company they called contacted me Monday. They said home treatment was not covered by Medicare part B under but my insurance company (Aetna medicare integration) would cover it fully.
They called back yesterday to say that it was not covered. The medicine was covered under my Medicare part D but I would need to pay $3100 plus $100 a day for the nurse. I told them I could not afford that and would prefer to try to get it at an infusion center. They tried to convince me to go thru with the home infusion. They are checking to see if their company has an infusion center here (Jacksonville Florida).
My understanding from research is that Medicare covers the drugs under part B but does not cover it for home infusion. I also recall reading that the drug coverage for IVIG was included in part B last January for a one year trial with a possibility of it becoming permanent. Does anyone know anything about that. The drug costs would push me into the donut hole for drug coverage on the first use.
Does anyone know of infusion centers located in Jacksonville?

limpy 12-05-2013 07:48 PM

My Ivig was paid under medical, not prescription plan. And there is an infusion center at the Pavillion fourth floor of UF Shands, Jacksonville.

clstewart81 12-06-2013 12:49 PM

I was just told today by my doc that I should start this therapy. If insurance doesn't cover it, oh well. There is no way I can afford this!

edwinlgreen 12-06-2013 01:08 PM

Quote:

Originally Posted by clstewart81 (Post 1034750)
I was just told today by my doc that I should start this therapy. If insurance doesn't cover it, oh well. There is no way I can afford this!

My understanding is this but I may be wrong.
If you are under medicare, medicare does not cover home infusion unless you are medically 'home bound'. It does cover infusion given at an infusion center or a hosipital. The largest part of the cost is for the drug itself. Medicare covers the drug under part B, the medical part instead of part D the drug part. If you are not under Medicare (or Medicaid) standard coverage rules may apply.

nanegg 12-06-2013 06:15 PM

I received IVIG for the first time 2 weeks ago. The first infusion center (Walgreens) said Medicare did not pay for it, even in the center. But that was wrong. (Maybe they didn't want to accept Medicare's mark-down of this expensive drug!). My neurologist's office found an infusion center (in Denver) that takes Medicare, and Medicare Part B definitely paid for it.

We are now at our winter home in Tucson, and I called around to find an infusion center, as I need another round. Every hospital I called knew who gives in-center IVIG for MG. I called that center, and they said of course Medicare Part B pays for it all the time.

I'm told Part D will pay for in-home infusions. I won't have Part D till Jan, 2014.
Hope this helps.
Nanegg


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