Iron Infusions

I recently moved to the US from Canada. I had an RNY in 2013. My iron is extremley low. I am going to my doctor to get a requisition for iron infusions. Does anyone have any experience with getting them done in the US? Does insurance typically pay for them? Do my iron and ferritin levels need to be a certain number to get approval? Any answers would be greatly appreciated.

different doctors use different lab levels to determine the need for infusions. Your doctor will likely refer you to. Hematologist to receive the infusion.

insurance does cover infusions. Most policies have the requirement that your deductible amount and your out of pocket maximum is covered before they will pick up the remaining cost.

Insurance may pay or not pay for iron infusion. Depends if your insurance covers and WLS or any complication from that.

Unfortunately my doc coded my need for iron infusion as a side effect of RNY. And my insurance refused to pay for it. Ouch. Very expensive.

Insurance SHOULD cover it as long as it is coded properly (as others have implied). Unlike Canada, here in the US coverage is driven by the insurance company, not the government, so it will depend on your policy.

I had the DS and have always had issues absorbing oral iron so I've had iron infusions on an off for years. It has always been covered by insurance but the amount out of pocket changed depending on the insurance policy I had (I've had several different jobs since having my DS). One policy I was paying approximately $100 per infusion out of pocket, but then another policy had me paying $0 per infusion out of pocket.

My hematologist felt that any ferritin below 50 was, in his opinion, iron deficiency anemia. It also helps to find a hematologist who understands malabsorption.

Any idea on how my doctor should code it to get the best chance at coverage?

Mine was always coded for Iron Deficiency Anemia with no mention of WLS. Other than that I really don't know.

My ferritin was at 13 in July 2017. Hate to see what it is now.

Can't imagine. When it first happened to me, my ferritin was 3. I was so sick. Once I was finally diagnosed the hematologist ordered the infusions. I got ferrilicit but it was a series of infusions - first twice weekly for a month, then once weekly for a month, then twice a month. The infusions themselves were easy.

The latest infusion (April 2017) was a newer drug that worked great. It was two infusions a week apart. Each infusion took 15 minutes and my ferritin level has maintained for over a year. I go back for labs in a couple of months. I feel great - no signs of anemia. I've done Ferrilicit (worked OK but lots of infusions over a series of months). Then I had Venofer. That also worked ok. The last time it was Injectafer. This is the newest drug that was designed for people who have trouble absorbing oral iron. It worked great for me - so far so good.

Good luck and get this taken care of. You'll feel so much better.