Does insurance generally cover home testing?

[ajc1991]

Hey everyone, I'm due to have surgery on Monday to have my aortic valve replaced with a mechanical one. My cardiologist, as well as my surgeon suggests it'd be a good idea for me to get a home testing kit. I agree it'd be a good idea. I'm wondering if insurance pays for this? I read here and there they have a tendency to cover it more if you have a mechanical valve. I know theyre about $1,000. And what about the strips? Are those covered as well? I have Anthem Blue Cross

EDIT: I just realized this should be in the "Home Testing" section. I apologize :/

 

[dick0236]

Insurance generally wants you to enroll in a program thru Alere, Coaguchek Patient Services, etc in order for insurance to participate. The programs normally provides the meter, strips, etc and charges about $25-$30 per test, of which insurance pays a percentaage and you pay co-insurance, usually 20% ($5-$6 per test). I am currently using Coaguchek Patient Services and am satisfied with that service.

PS. Normally you can enroll in those programs after 90 days on warfarin.

 

[pellicle]

I have a coaguchek XS, it costs about $500 and the strips about $5.50 if you just pay for them. Seems like the whole insurance rort is just a money pushing game.

Best wishes for the surgery, we'll all be rooting for ya

 

[pellicle]

PS : its fine here, the section categorisation is loose at best

 

[idn88]

For those of you who purchase their own machine / strips - how do you get your warfarin prescribed? My doctor doesn't seem to want to touch it. I want to buy my own machine and strips, but I get nothing but a run around. Ask the doc- they say call insurance. Call insurance, they say ask the doc.? I would be happy to pay for the whole thing out of pocket if they would just let me.

 

[dick0236]

For those of you who purchase their own machine / strips - how do you get your warfarin prescribed? My doctor doesn't seem to want to touch it. I want to buy my own machine and strips, but I get nothing but a run around. Ask the doc- they say call insurance. Call insurance, they say ask the doc.? I would be happy to pay for the whole thing out of pocket if they would just let me.

Warfarin is one of the most widely used AND widely mis-used drugs in the world. Doctors that prescribe it take on a fiduciary responsibility and are often mistrusting that patients can test and/or report results properly. My PCP monitors mine and he was reluctant to let me self-test, even tho I've been on the stuf "forever".....so I bought a meter and strips from ebay and continued to go to his office monthly for his lab test and kept them aware that my results dovetailed with theirs. That solved the problem of having the warfarin prescribed. I did this for a couple years, until Alere recalled the strips for my INRatio2 meter. By that time he became aware, and comfortable, that I could be trusted to "self-test" and signed the Rx form.....so far it is working well. I still go in to his office a few times each year to validate that my meter (CoaguchekXS) agrees with their meter(CoaguchekXS).

I am aware that the $25+ that is being charged to insurance seems a little high but my doc's office receives $10(he continues to monitor my results) of that $25.... and I am assured of prompt delivery of "trusted" supplies as needed.....and a meter that is kept up to date......and, of course, better control of my INR. My out-of-pocket cost is about $6, which is about what I payed for the strips on ebay.

PS: I was one of those who often misused warfarin.....a long time ago, when I was in my 30's. After one stroke I became a believer that you DON'T screw around with warfarin.....so I can understand a doctors reluctance to turn warfarin management over to the patient.

 

[pellicle]

Hi

For those of you who purchase their own machine / strips - how do you get your warfarin prescribed? My doctor doesn't seem to want to touch it. I want to buy my own machine and strips, but I get nothing but a run around. Ask the doc- they say call insurance. Call insurance, they say ask the doc.? I would be happy to pay for the whole thing out of pocket if they would just let me.

I'm an Australian (and live also in Finland from time to time), so it may be different here. In Australia I consult with my Dr who (knows and) trusts me. I demonstrated to him that I can look after my self (just took a conversation really). I have spreadsheets of my data which I can show him although he is relatively uninterested in looking these days. Similarly my surgeon knows and trusts me (and has seen one year of my data) and should he be inclined to could also check with me or my Doc.

Like Australia the medical system in Finland (and most of Scandinavia and Europe really) also takes the view that I'm the one most likely to be harmed by my actions and allows me to be a responsible adult if I wish to manage myself. All had to do here was demonstrate to the Dr that I was able to do that. After all, one could come to more harm faster by driving drunk and or texting on the phone while driving (drunk?)... where do you draw the limits on the Nanny State looking after you ... but then that's the "Land of the Free" for you.

PS: when it comes to "duty of care" I find it interesting that the clinics may actually cause a problem (with their ignorant management practices) leaving you with an injury ... that would be somehow called "statistics" ... Yet if you were at a clinic and regularly forgot to take your warfarin (but lied about it) how would that be any different? No one at the clinic ensures you actually take your stuff.

I feel that clinics should be there to provide management for those who wish it / need it but that for those who are informed and capable why not allow them to be adults?

Who monitors the diabetics (who are on a much more dangerous regime if treatment).

 

[tom in MO]

For those of you who purchase their own machine / strips - how do you get your warfarin prescribed? My doctor doesn't seem to want to touch it. I want to buy my own machine and strips, but I get nothing but a run around. Ask the doc- they say call insurance. Call insurance, they say ask the doc.? I would be happy to pay for the whole thing out of pocket if they would just let me.

Get a different doctor. Modern practice of anticoagulation therapy recommends home testinf if you are mentally and physically capable. It is coverd by medicare.

Due to liability some will not prescribe warfarin and allow for home testing. My gp says to get my warfarin from my cardio, although he's willing to prescribe blood pressure and cholseterol meds. I said, no thanks and have my cardio handle the whole heart meds.

My cardio lets me do what I want. His practice includes a doctor and nurse that handle anticoagulation therapy. I self test and call in the results. When my insurance required a service, I used that, but the insurance company dropped the service. The provider wants me to test weekly and requires a script to that effect. My cardio's office wrote it, but requires me to test on a less frequent basis.

 

[ajc1991]

PS: I was one of those who often misused warfarin.....a long time ago, when I was in my 30's. After one stroke I became a believer that you DON'T screw around with warfarin.....so I can understand a doctors reluctance to turn warfarin management over to the patient.

Dick, if I may ask, how did you misuse the Warfarin that winded up leading to a stroke?

 

[dick0236]

Dick, if I may ask, how did you misuse the Warfarin that winded up leading to a stroke?

Back in those olden days warfarin management was pretty loose. Testing protocols where more "art" than "science", very little information was available outside medical journals and those were not widely available(no internet) and, frankly, I treated warfarin like I would an asparin. I went on a several day fishing trip and forgot to take my warfarin with me. I didn't think it was a big deal....WRONG!! My stroke occurred the evening of my first day back to work. That was in 1974. It was a hard lesson, but I now seldom forget my pill(never forget two pills) and I have had NO trouble since.

 

[ajc1991]

Thanks for the reply, I appreciate it. Glad you've been good since