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does Medicare cover intravenous iron therapy

Does Medicare Cover Intravenous Iron Therapy?

Iron deficiency, or anemia, is quite common. In fact, the World Health Organization (WHO) says it is the most common nutrient disorder in the world.  

Iron deficiency can occur for many reasons. Blood loss, some medications, certain chronic medical conditions, and diet are some common ones. 

Fortunately, there things you can do to prevent iron deficiency and treatments if you suffer from it. Sometimes you can treat it by lifestyle changes and dietary supplements. However, in cases of extreme iron deficiency, you may need stronger treatment such as iron therapy.  

If you suffer from sever iron deficiency, and have Medicare, you may be wondering “Does Medicare cover Intravenous Iron Therapy?”  

In this article, we answer that question in clear, plain English. You will also find the average costs of intravenous iron therapy and other helpful info. 

Does Medicare Cover Intravenous Iron Therapy? 

The short answer is yes. Medicare will cover the cost of intravenous iron therapy. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to cover the costs. Below we look at what these are so you know what to expect. 

Original Medicare (Medicare Part A and Part B) provides coverage for intravenous iron therapy costs. Since most iron infusions take place in an outpatient setting, Medicare Part B will foot the bill for this treatment. However, Medicare Part A may cover iron infusions when they occur in an inpatient setting.  

A key condition Medicare requires in order to cover treatments is whether or not the treatment is medically necessary. And, in the case of iron infusions, Medicare does consider them to be medically necessary. This is especially true for those who are receiving hemodialysis, have iron deficiency due to chronic kidney disease, and those who are undergoing chemotherapy.  

Medicare recipients who have an iron deficiency but cannot tolerate oral iron medications or are unable to absorb iron from oral iron medications are also eligible for iron infusions. However, in this situation, you will need to submit documents from their healthcare provider to back up these claims.  

Medicare Advantage plans (Medicare Part C) also provide coverage for intravenous iron therapy. They cover everything Original Medicare covers as well as some additional benefits. However, exactly what they cover and what the out-of-pocket costs are will vary depending on the specifics of your plan.  

How Much Does Intravenous Iron Therapy Cost? 

An intravenous iron infusion may cost from around $400 to more than $4,000. What side of that price range you fall on will vary depending on several factors. One of the main factors is what type of iron infusion you receive.  

The Three Common Types Of Iron Infusion 

  • Iron Sucrose: Iron Sucrose is administered through a slow infusion. They can take as little as 2 minutes or as long as 4 hours. One of the more common brand names this treatment goes by is Venofer.  
  • Ferric carboxymaltose: Ferric Carboxymaltose is usually split up into two doses. Patients get these doses about seven days apart. This treatment often goes by the brand name Injectafer. 
  • Iron Dextran: Iron dextran is prepared in large doses when necessary. This treatment is more common after certain surgeries. It has two main brand names which are Dexferrum and Infed. 

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover eyelid surgery?

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