Key Takeaways
- Medicare Part B covers the full cost of at-home IVIG treatment for primary immune deficiency disease (PIDD), including both the medication and related services.
- For conditions not covered under Part B, Medicare Part D plans may cover IVIG medications and supplies. Out-of-pocket costs can vary based on the plan’s formulary and cost-sharing structure.
- Compared to Original Medicare, Medicare Advantage (Part C) plans can have different coinsurance or copayment costs for IVIG treatment, making it important to review specific policy details.
The amount Medicare pays for intravenous immune globulin (IVIG) depends on the condition diagnosed and whether the treatment is provided in an inpatient or outpatient setting.
If you receive a diagnosis of primary immune deficiency disease (PIDD) and have Original Medicare, Part B will cover the cost of at-home IVIG treatment. This includes the cost of the drug, as well as other items and services related to at-home IVIG treatment.
Part B will also cover IVIG that’s administered in a hospital, outpatient clinic, or infusion center. Depending on the condition being treated, Part B may cover both the medication and the cost of administering it.
If your condition isn’t covered by Part B, you may be eligible for coverage through a Part D (prescription drug) plan.
Part D, which is sold by private insurers, generally includes coverage for the medications and supplies needed for at-home IVIG administration. Out-of-pocket costs depend on your plan’s formulary and cost-sharing structure.
IVIG coverage and associated costs also vary with Medicare Advantage (Part C).
Medicare Advantage is also sold by private insurers. These plans may have different coinsurance or copayment costs than Original Medicare, so it’s important to review your policy details.