Medicare to start covering home infusions

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    • #117748
      SandraP
      Participant

      Beginning January 1, 2021, Medicare Part B will cover 80% of the cost of nursing care for home infusions of IVIG for Medicare enrollees. If you have received your new Medicare and You booklet, you’ll find a mention of this on page 42. A very long, detailed explanation of the new benefit is on the CMS website. I have confirmed with Optum, my home infusion service, that their billing department is scheduled to receive training soon on how to bill for this benefit and will start billing Medicare on January 1. This will save me thousands of dollars every year. The IVIG drug is covered separately by Medicare Part D, and I’ve been getting that benefit all along (paying 20% co-pay), but I’ve been paying for nursing services at home in full out of pocket. Medicare did a years-long demonstration project and concluded that home infusions have health benefits for patients that justify the coverage.

    • #117749
      SandraP
      Participant

      Here’s the CMS.gov page that explains the home infusion benefit: https://www.cms.gov/files/document/mm11880.pdf

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