Does Insurance Cover Iron Infusions?

Does Insurance Cover Iron Infusions?

Iron deficiency can be quite a problematic health problem and it is important to ensure that you are getting appropriate medical care.

It happens for many different reasons and this can sometimes lead to the development of anemia. Iron infusions are one way that the symptoms of anemia and iron deficiency are treated. 

Health insurers, such as Medicare, will cover the costs of these iron infusions if you meet the criteria set out by them. 

What is an Iron Infusion?

Iron deficiency can be treated in other, less invasive ways. For instance, there are iron supplements that can be taken to boost the iron levels in your body.

Lifestyle changes are also a great way to manage iron deficiency as there are lots of foods that can provide iron for your body. 

However, sometimes, this is not enough. Some people suffer an iron deficiency that is so severe that they need an iron infusion to replace the iron that their body needs.

This can be administered in three different ways: 

  • Iron sucrose infusion. This is a type of iron replacement that is administered via an infusion. It takes 2-5 minutes. Sometimes it is mixed with another fluid which would take a little longer to infuse into your blood. If this is the case, it could take anywhere up to four hours. 
  • Ferric carboxymaltose. This infusion is given in two different doses around a week apart. 
  • Iron dextran. This infusion is administered in very large doses. Usually this happens in very extreme situations, such as after extreme surgeries.

If you have to have iron infusions to help to treat your iron deficiency, your doctor will decide on your dosage through certain individuals.

It will be dependent on your weight and height because this will depend on how much iron your body will need.

After you have completed the treatment, then your iron levels will be monitored. Depending on how your body responds to the treatment, you may have to have this treatment again. 

Does Insurance Cover Iron Infusions?

Insurance companies do often cover iron infusions. For example, if you are insured through Medicare, iron infusions are covered if you meet the following criteria. 

If you require an iron infusion after you have had a major surgery, then this will count under Part A of Medicare. 

Medicare will assess the medical necessity of the treatment and this will determine whether it is paid for or not.

The most common reason that iron infusions are considered to be more necessary is when the iron infusions are administered because of a chronic kidney disease.

If you are receiving chemotherapy and you require an iron infusion as a result of this, you will be covered.

Another reason that iron infusions are necessary is because the person who requires it cannot take the oral supplement. This will have to be proven by the physician in order to receive the funding from Medicare.

Medigap and Medicare Advantage plans do not actually offer any extra benefits when it comes to iron infusions, however, they can help to reduce the extra expenses that are associated with a treatment of this kind.

If you are a member of these plans then you will need to contact the company to see whether there is any extra help or to check what coverage is available.

Side Effects of Iron Infusions

Side Effects Of Iron Infusions 

There are a few side effects that are associated with iron treatments and iron infusions. For example, itching, swelling and discomfort are common side effects.

Some patients complain of a change of taste, however, this is usually short lived. Iron infusions can also cause headaches, cramps, nausea or vomiting.

Before you have an infusion, your blood pressure and heart rate will be taken, and this will be monitored during and after the procedure too.

You might be asked to stay for half an hour after the infusion in order to monitor your response.

Another rare side effect is an allergic reaction to the infusion. This is usually avoided by doing a small test beforehand to check that you won’t have an allergic reaction. 

If you are taking any other medication or supplements, it is very important to let your doctor know as they might interfere with one another.

If you have taken the infusion, it sometimes can take a little while for any complications to occur. Sometimes this comes later but it is often not very severe.

The side effects may include the following:

  • Swelling on the arms, leg, feet or face.
  • Dizziness.
  • Nausea.
  • Chest pain and difficulty breathing.
  • Rash.
  • Low blood pressure.

How to Prepare for an Iron Infusion?

Your doctor will run through your preparation for this infusion. On the day of the infusion, it helps to eat your breakfast and lunch and ensure that you are going about your normal day.

You should continue to take your medications. You should always have something on hand to call for help in case of an adverse reaction.

Frequently Asked Questions

How Much Does an Iron Infusion Cost?

The price of an iron infusion differs depending on where you go and what doctor you get to do it for you. It differs greatly but it is very expensive.

If you are not covered by insurance, then having to fork out to pay for an iron infusion can be very stressful.

Are Iron Infusions Safe?

There are some risks associated with iron infusions. It can cause your blood pressure to drop which can cause further problems.

If  you are predisposition to low blood pressure, iron deficiency can make this worsen. It can also heighten blood sugar imbalances as there is sugar in the formulation of iron that is being infused into your body.

Iron can irritate certain gastric problems and so can be very uncomfortable. For the most part, however, the infusions are safe.

Final Thoughts 

So, insurance does cover iron infusions if you meet the criteria needed. It will have to be a medical necessity and you will need proof of the need from your physician.

Frequently Asked Questions

At what point should you get an iron infusion?

Patients who receive IV iron usually do so because they cannot take oral iron. These include the following: Patients who are bleeding in the gastrointestinal (GI) tract (the gut) and need to replace iron quickly. (IV iron is absorbed by the body more rapidly than oral iron.)

Are iron infusions worth it?

Iron infusions are an effective way to treat IDA. They’re a good choice if oral iron supplements aren’t right for you. These IDA treatments are relatively safe, but can cause serious allergic reactions for a small number of people.

Can my doctor give me iron infusion?

Iron infusions are usually prescribed by doctors to treat iron deficiency anemia. Iron deficiency anemia is typically treated with dietary changes and iron supplements that you take in pill form. In some cases, though, doctors may recommend iron infusions instead.

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