Living with Polyneuropathy CIDP, GBS, & CMT

Home IVIG nurse on Medicare?

I will be 65 in six months and need to start planning for transitioning over to Medicare. I know one of the Medicare sub parts will cover the medicine, but is there a sub plan that will cover the cost of a nurse coming to my home to do the infusion?

Hi David,

I am Anne. I turn 65 in 10 months and am looking for my resources as well. So glad to hear there is a plan that covers IVIG. Nit sure how good it is and if its only 80%. If that, treatment will be so costly and it may be beneficial to consider a full insurance plan versus supplemental plan or plans. This is what i wondered.

I got IVIG for 6 months, had to stop for 3 months until cause was found for profuse pain and swelling in my arms. Basically, my veins are destroyed from all the infusions. I just had to switch to Hizentra…same medication but into one’s fatty tissue instead of one’s veins. I know Hizentra is covered but no idea yet on nursing services. If i learn anything, i will share it with you. Hopefully you will share your info and research :hugs:

And, what supplemental plan did you find that actually covers IVIG. i looked but didn’t find anything…?

Regards, Anne

No, Medicare does not cover the cost of nurses for home infusion. The only way to get full coverage is to go to an infusion center. For home infusion, Medicare Part D drug coverage pays 80% of the cost of the IVIG fluid. I get 40 grams five times in every four-week cycle. I pay almost $800 a month out of pocket for the IVIG and more than $2,000 a month for nursing service. My monthly out of pocket bill is more than $3,000. I take Gamunex, and not a single infusion center near me uses it. They all use either Privigen or Gammagard. I urge you to go to an infusion center if you can’t afford the cost of home infusions.

Once you’re on Medicare, you can’t get a “full insurance plan” from any private insurer. You can buy supplemental plans to cover the 20% that Medicare Part A and Part B don’t cover, and you can get Part D to cover drugs. You can’t go back to private insurance.

My Medicare Part D drug policy is with Cigna. They cover my IVIG 80%. If infusions are done in an infusion center, they’re covered by Part B and your cost is significantly less — or zero.

Awesome and thanks Sandra :pray:

Anne Vonick

I am also close to Medicare age. I can’t take IVIG so I take subQ. Would I have to go to an infusion center for that?

I have been on IVIG for 7 years through medicare and have a plan F medigap policy from USAA and I have yet to pay anything for my infusions. You need t o take a closer look at this. Plan F is expensive as plans go but nowhere near paying 20%.

My Humana Advantage plan pays all but $100/month. Nursing services at home (2 days every 3 weeks) paid 100%

I go to an infusion center. I have Medicare and Plan F through AARP. My monthly premium is around $250 but other than that, I’ve never had to pay a bill (& the IV fluid is about $5000 per time). I get it every 2 weeks so Medicare alone would mean I’d pay $1000 every infusion, or $2-3000/month out of pocket! That’s more than all the money I get every month from SocSec! So this is great for me!

Hi David bry here I’m 61 and I get ssdi I’m eligible for Medicare but am lucky to be on my wife’s insurance but if I wasn’t I would choose a Medicare advantage plan if I wasn’t I get plasmapheresis every 4 weeks it is very expensive the 20% that I would have to pay with regular Medicare would put me in the poor house so maybe look to something like that do your research and good luck

I do my home infusions through my part d insurance (superscript). I have a deductible in January which i pay on monthly, then a little over $8 per infusion. This covers the nurse, supplies, If, etc. So it runs a little over a $100 a month. I did infuse at both the hospital and a clinic at different times but as I have to do a slow drip due to side effects my infusion take a about 6 hours. Infusing at home is well worth it.

SsandraP – it looks like a few of the responders below have found supplemental coverage that pays for home nursing. You may be paying more than you need to.

DocMac – I will look into Humana Advantage! Thanks for the tip.

Herself7 – did you mean “SilverScript” rather than “superscript”? Here’s their website: https://www.silverscript.com/

They have many plans. Which one are you on?

Thanks in advance.

I don’t want to be part of an HMO. Too many friends have horror stories about their HMOs. But I’m glad to read the responses here. I will look further into other plans before I make a final decision by Dec. 7, the closing date. Thanks!

I’m confused. Are you saying that Plan F pays for your IVIG as well as the home nursing? Do you still need Part D for drugs? Does that cover part of your IVIG cost, with Plan F paying the rest?

I was on Medicare (and medigap) for several years before I developed CIDP. When I started infusions I looked into all possible options for covering the home nursing and found nothing. I was told that after the initial enrollment period (the six months after I went on Medicare) ended, I could legally be denied coverage if I tried to change my medigap plan. And in my circumstances, I probably would be denied. A nursing supervisor also warned me not to change my insurance because I could end up with no supplemental insurance at all. I will call my insurer Monday, but I suspect I will be told the same thing I was told three years ago.

Medicare along with plan F pays 100% of my IVIG infusions. I don’t know about at home infusions personally. Part D is not involved due to the expense - all is covered by Medicare and Part F supplemental insurance.

Skiptech, are you saying you infuse ar home or at an infusion center with your Part F?

I infuse at a local hospital. I live in a rural area and home infusions are not available.