does original medicare cover izervay?

[axeman462]

Anyone have any experience with Izervay? Its a new drug approved back in august for Macular Degeneration. Its an injectable, goes right in the eye, a Part B drug

 

[kgmom219]

Full FDA approval, so yes. And if in a docs office, its B.

But I would tell the client to confirm with the doc.

 

[axeman462]

Full FDA approval, so yes. And if in a docs office, its B.

But I would tell the client to confirm with the doc.

thank you, thats what I was thinking.
When I talked to the customer this morning, I asked what did the doctor's office say, she said his exact words were "medicare would probably cover it".
Her doctor's office has never instilled a lot of confidence in me ‍

 

[AgentGeneral]

thank you, thats what I was thinking.
When I talked to the customer this morning, I asked what did the doctor's office say, she said his exact words were "medicare would probably cover it".
Her doctor's office has never instilled a lot of confidence in me ‍

Don't ya just love those answers? "probably"...if I only had a nickel....

This one threw me for a loop a few weeks ago, not the same question as yours. more general. The most correct answer came from the billing dept where the woman went to get her injections. I was way off the mark. The MD injections in general had me upside down a few weeks ago.

A 3300 injection ended up being $60 plus copay.

I know thats not what you were asking, just thought I'd share since the MD injections been on my mind lately.

On yours, yes, FDA approve AND on label use I'd say yes. covered. Part B.

 

[DS4]

Anyone have any experience with Izervay? Its a new drug approved back in august for Macular Degeneration. Its an injectable, goes right in the eye, a Part B drug

Covered by Part B? I would think it would be completely safe for the MB to inject their own eye! Lol

 

[ICACharleston]

The most correct answer came from the billing dept where the woman went to get her injections. I was way off the mark. The MD injections in general had me upside down a few weeks ago.

A 3300 injection ended up being $60 plus copay.

Doctors only know that if it's turned down by insurance the patient is still on the hook, but for the whole amount not the Medicare approved amount. So for the doc, it's a win-win more situation.

 

[AgentGeneral]

Doctors only know that if it's turned down by insurance the patient is still on the hook, but for the whole amount not the Medicare approved amount. So for the doc, it's a win-win more situation.

True

***sigh***

Step therapy. Common way.

Hopefully most docs offices smart enough to get auth b4hand

 

[Cenla Agent]

Doctors only know that if it's turned down by insurance the patient is still on the hook, but for the whole amount not the Medicare approved amount. So for the doc, it's a win-win more situation.

It is a win IF they can collect that 20%.