Getting $ from insurance with DX of possible hyper-coagulable state and multiple PEs?

[frank10b]

I have medicare and BCBS Fed, is there any way they will pay for Home INR? What can I do to bolter my case? I have a pig AVR/MVR from 2002 but new mgn issues with INR because of MS and liver function test issues. Now that I am eating more kale, green veggies I am worried that my INR will start to yo-yo.

 

[geebee]

I could be wrong but I think I read somewhere that Medicare will only pay for a home tester if you have a mechnical valve. However, it never hurts to try. I would contact QAS and see what they have to say. They are very good at getting things approved.

 

[Blanche]

Perhaps the following link from Medicare will be helpful to you. It is my understanding that Medicare will cover a home monitor with supplies for patients with mechanical heart valves who are covered by Medicare. I don't believe they will cover people who are taking anticoagulants for other reasons.

However, the information in the link is very valuable for other purposes. It certainly made anticoagulation more understandable to me.

https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=72&

Regards,
Blanche

 

[frank10b]

Thank you for the reply, who is QAS and how do I reach them. I left an email for the ptinr.com people at the top of the page

 

[geebee]

Thank you for the reply, who is QAS and how do I reach them. I left an email for the ptinr.com people at the top of the page

Same folks. If you do not hear back, send a PM to our member QAS Lance.

 

[marie]

keep us posted

keep us posted

Keep us posted as to how this works out for you with your insurance. Have you had any problems at all with this type of coverage. I have the same coverage and that is why I'm being so nosey. My husband is a retired federal employee.
Earline

 

[frank10b]

Keep us posted as to how this works out for you with your insurance. Have you had any problems at all with this type of coverage. I have the same coverage and that is why I'm being so nosey. My husband is a retired federal employee.
Earline

do u have std or high option and have u noticed any difference?

 

[marie]

do u have std or high option and have u noticed any difference?

We have and have always had standard not basic self and family. We haven't come out of pocket for anything other than co pay on drugs. My husband is 68 and I am 66 both retired.

Neither of us has had any major problems however but I am scheduled for surgery shortly.

What has your experience been with medicare and BC/BS?