Home Testing Covered?

[JetService]

Hi all! Its been a while for me!!!

Its been a year and a half since my VR and my Coumadin Clinic still can't seem to control my INR. I've tested weekly for most of the 18 months. I've never had more than 2 consecutive good readings. I've been both high and low about 50/50. The highest was around 7 and the lowest around 1. My target is 2.5-3.5. My therapy is 10mg Mon, Wed, Fri and 7.5mg Tue, Thur, Sat. They told me "every other day" so on Sunday, I take 7.5 or 10 depending on if last reading was above or below 3 (otherwise I use their custom instructions if reading was bad). Usually they just change dosage days ("take 7.5 all week and get tested again" or "take 10 Tues. and regular dose rest of week", etc. etc.)

Anyway, my question is at what point can I lobby to have my ins. co. cover a home tester? It seems these constant lab runs are costing them more and it would seem with the trouble they are having, constant monitoring would be prudent. Has anyone ever had PT control problems for this long? My diet isn't very different and I'm good about avoid things that compromise the medicine's objective. Thanks for any input!

 

[warrenr]

Home Testing

Home Testing

Jetservice,

I don't know about all medical insurance companies but Medicare sent a bulletin to it's primary care providers in 2002. It was letting them know that medicare would cover cost of home testing. They have strict requirements as far as who is eligible and the bulliten was quite proactive about home testing. I will find the link and send it to you.

 

[bvdr]

Hi, nice to hear from you again. I would definitely go for home testing and lobby for adjusting your own dose according to pre-set guidelines. Contact QAS (there is a link on this site) and they will help you get things in motion. I hope everything else is going well.

 

[warrenr]

Jetservice,

Here is the link

http://www.cms.hhs.gov/manuals/pm_trans/AB02064.pdf

 

[Barry]

FYI, I've found that my INR is much more erratic on generic Warfarin than on brand-name Coumadin.

 

[Ross]

FYI, I've found that my INR is much more erratic on generic Warfarin than on brand-name Coumadin.

You keep saying that, but it doesn't hold true for everyone. Very few have any problems between the two.

 

[catwoman]

JetService:
I got my ProTime 3 machine in November 2003, 5MO after my MVR. At that time, my insurance plan covered 100% of DME (durable medical equipment). At this time it's 90% if in network, 70% out of network. Even if the company is out of network, you **can** get it certified as in network. I got QAS certified in network last month even though there's an in-network provider (that didn't have a clue what it was doing!).
QAS took care of all the paperwork with my PCP and insurance company.

Barry:
I agree with Ross. I can justify when my INR has varied: illness, an Rx, change in diet, change in activity levels, etc. -- things that would have affected my INR with Coumadin.