INRatio 75% approved by insurance

[Ticky]

Heard from QAS this morning that Carefirst has agreed to pay 75% of my home INR monitor. Is this typical? Also, does that mean they'll pay 75% of the testing strips too?

Where can I buy the strips for the best value?

Thanks,
Lisa

 

[catwoman]

The monitor is DME -- durable medical equipment, E1399 code. If QAS puts down E1399 for the strips, your insurance company will probably pay for the strips.
Mine did when I got mine through QAS. However, I now have to go through Raytel, which refuses to use E1399 and uses a disposable medical equipment code. My company's insurance contract pays for diabetics' disposable medical equipment items -- but not for PT/INR testing.

So, it may boil down to the insurance code.

 

[Karlynn]

At this point, just about anything is "typical". All things considered, given the freedom of home testing, I'd be happy with a 75% coverage.

 

[jeffp]

The monitor is DME -- durable medical equipment, E1399 code. If QAS puts down E1399 for the strips, your insurance company will probably pay for the strips.

75% is about right. Most policies cover 75 or 80% of the cost of durable medical equiptment, often after an initial deductable. As for coding, the monitor certainly is a DME; it has a greater than a year lifetime and is usable multiple times. The strips shoud really never be considered as DME; they're a one time use disposable testing supply item. If you get them covered under E1399, that's more of a fluke than anything else; don't depend on it happening consistently.