Not the kind we bring you. Is IV therapy covered by Medicare? Part B pays for infusions at home when a doctor has ordered certain drugs into a vein, and it pays nothing toward a vitamin bag you booked off a menu in Tulsa after a hard week. Our price is the price, and that's the answer we give on the phone.
We list our sources at the bottom so you can check us.
There's a real Medicare benefit with our line of work in its name, and that's where the confusion starts. The Centers for Medicare and Medicaid Services, the federal agency that runs the program, opens its own page on it this way. Home infusion therapy involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Read that cold and it sounds like a nurse at your kitchen table with a bag on a hook.
Then the agency says what the benefit actually buys. The Medicare home infusion therapy benefit is for coverage of home infusion therapy-associated professional services for certain drugs and biologicals administered intravenously, or subcutaneously through a pump that is an item of DME, effective January 1, 2021. Two words in there matter: certain, and drugs. Normal saline with a B-complex in it, booked by you from a menu because your week went sideways, isn't a drug a physician put on a plan of care. Nobody prescribed it, so that sentence never reaches us.
It pays for the visit, too, which surprises people who assume Medicare only covers hospitals. The program's own coverage page puts, in the list of what Part B buys at home, therapy services needed to safely administer certain intravenous or subcutaneous drugs in your home, like nursing visits, caregiver training, and patient monitoring. Nursing visits. Monitoring. Those are the words we'd use for what our nurse does in your living room.
The hinge is the same word again. Certain drugs. If your oncologist or your infectious disease doctor has you on something that runs into a vein for weeks, that's the service those sentences describe, and it arrives through a supplier your doctor's office sets up. We wrote about the two services that share the name separately, because people call us looking for the other one about once a week.
Not one national desk, it turns out. Medicare's plain-language page on coverage says the decision rests on three things. Medicare coverage is based on 3 main factors: federal and state law, national decisions the program makes, and then this one. Local coverage decisions made by Medicare claims processing companies in each state. The same page says what those companies are weighing. These companies decide if something is medically necessary and Medicare should cover it in their area.
Medically necessary is the whole test. We don't ask you for a diagnosis when you book, and we don't send one anywhere, because there isn't one in the transaction. You are buying a liter of fluid and some vitamins from a nurse who comes to you. That's a wellness purchase, and it sits outside the question those claims companies are set up to answer.
No. Our FAQ answers it in one word before anybody picks up a phone: do you take insurance? No. One flat price, no surprise bills. Better you read that here than find it out on your doorstep.
If you're on the covered side of this, Medicare doesn't pay all of it. Its coverage page is specific about your share. In most cases, you pay 20% of the Medicare-approved amount for home infusion therapy services, and for the equipment and supplies you use in your home. And before that twenty percent starts, The Part B deductible applies for the equipment and supplies. So even covered, there's arithmetic.
On our side the arithmetic is shorter, because the number on the page is the number. Simply Hydrate is a plain liter of normal saline at $99 all in, the NAD+ bags sit at the top at $399, and every other bag carries its own number on its own page. Same bag, same price in every city on our list. Hangover Helper is $179 in Bixby and $179 in Tulsa, and it is one of the three that move most out in Bixby. We take FSA and HSA cards. If it turns into a monthly habit, the membership math is better than paying per visit, and we'll say so rather than let you book twelve single bags.
An injection add-on runs $25 on any visit, and your first B12 shot is on us right now. That's the whole price list. No claim, no code, nothing to appeal.
This post is not medical advice, and reading it doesn't make us your nurse. A bag from us is a wellness visit. What your own plan will pay is a question for Medicare, or for whichever office wrote your orders.
Home Infusion Therapy, the program description, the Centers for Medicare and Medicaid Services, a government health agency
Home infusion therapy services, equipment, and supplies, Medicare.gov, the coverage pages of a government health agency
What Original Medicare covers, Medicare.gov, a government health agency
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