Medicare Reimbursement amount for infusion center

clo2014 said...
Ok... Just checked my insurance and the new infusion clinic has already ran it thru.... My weight and dosage was the same as last time. Medicare (original) is now paying almost 800.to 900. Less on the medication per infusion on me from what I could see. I also get Remicade.

I'm waiting on the hard copies but wanted to give you guys an estimated amount.

Clo

Interesting. I was looking at recent claims for my infusions and noticed that UHC started paying my provider about $900 less than they were. I guess whatever Medicare does trickles down. Sounds like a mess with patients just pawns for both sides.

Like everything else there’s going to be loopholes. Only certain meds are negotiated I think. I am hoping it will mean Medicare users can qualify for the copay cards most drugs have? I was told by a pharmacy person that the reason we don’t qualify for those programs is because Medicare doesn’t allow negotiations We’ll see.

I’m more optimistic about the $2k out of pocket limit set to start next year. But I haven’t seen the language of the rule or heard if it means only for covered medications—and the the plan Ds will just not cover any of the meds they consider too expensive.