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Insurance co-pays for IV-infusion of Boniva, etc.


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#1 JJ-Knitter

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Posted 12 August 2008 - 11:50 AM

Hi folks!

I've just learned something interesting. It seems if you have the IV-infusion done in a doctor's office that's located within a hospital, the insurance companies treat the claim differently than if it is done in a doctor's office that is NOT located within a hospital.

In my case, the rheumatologist, Infusion Team and pharmacy are all located within the hospital and my co-pay is $254. If I get the infusion done at a local group practice of rheumatologist doctors, my co-pay goes down to $10 (hear that? Ten!) dollars.

Wow! I hope this bit of hard-earned info might be of use to someone else.

:)

#2 Sheryl

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Posted 12 August 2008 - 12:21 PM

JJ, Thanks for the information. I sure hope it helps someone else in our group or a friend or relative. Great News!
Strength and Warmth,
Sheryl

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#3 razz

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Posted 12 August 2008 - 02:14 PM

JJ Knitter,

I have to get regular infusions for osteoporosis and have been getting them at the hospital. My last one was the yearly Reclast this past March. When I got my monthly insurance statement recently I saw a charge for $5,000.00 dated in mid-March. I thought what did I have done back in March? :o The only thing I could remember was the Reclast infusion. What an eye opener! I did not know the huge difference in cost from the hospital versus a local practioner. Thank you for this information. I didn't know I had a choice. I will be weighing my options next time I'm due for an infusion.



Hugs,
Razz



I'm still standing......
Live well, Laugh often, Love much

#4 JJ-Knitter

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Posted 12 August 2008 - 04:50 PM

Hey Razz,

It's worth checking with your insurance to see how *they* handle it. It was actually a very helpful young lady at my insurance company who told me about it. I'd called to ask if there was an infusion version of something other than Boniva that would be on the preferred list and cheaper. I called my general practitioner to see if she could/would do it in her office. She didn't but gave me the name of a local "arthritis clinic" (the group practice of rheumatologists) who do infusions in their office setting.

Hugs (gentle ones, of course!)

JJ

#5 razz

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Posted 12 August 2008 - 06:59 PM

JJ Knitter,

Thanks for the tip! I didn't realize there were choices available but I will definitely look into it.


I like your beautiful white shawl.
Razz
:)
Live well, Laugh often, Love much

#6 Peggy

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Posted 13 August 2008 - 06:03 AM

That's where living in a small rural town has it's pitfalls! I don't have a choice as the only place to have it done is as an out-[atient at our hospital. I know the IVIG treatments were terribly expensive and I won't know until October if it has still worked. Good for you for checking this out!

Warm hugs,

Peggy

#7 JJ-Knitter

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Posted 13 August 2008 - 04:33 PM

Hi Razz,

Glad you liked the shawl. I knit one of those for each child in our family and circle of friends when they marry and have *their* first child. That one nearly didn't get out the door because Cat decided it was hers. I have to admit, there are days when curling up in a patch of sunshine with a nice wooly blanket would be my idea of the perfect laugh too! LOL

JJ (obviously) Knitter

#8 JJ-Knitter

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Posted 13 August 2008 - 04:40 PM

Hi Peggy,

I hope the IVIG treatments work out great for you! You'll let us know, won't you?

I'm originally from a small rural town, too. Folks there have to either travel 90 miles over mountain roads to get to anywhere with real specialists; although, in the last few years, some of the specialists do come in anywhere from once a week to once a month. So many of the people living there are getting quite elderly and there is no public transportation to the big city. There are rumors of a bus service starting up, so everyone has their fingers crossed. My mum says she would cross hers if she could... :lol:

JJ