Does Medicare Part B cover sodium chloride solution?

Posted by lora jo @ljfoo, Mar 23, 2022

CVS says that neither Medicare Part D nor Medicare Part B covers the 3% or 7% sodium chloride I need. I've read on this discussion group that some of you have been able to get your sodium chloride covered by Medicare Part B. How did you do that? Is there a specific Diagnosis Code that your doctor has given your pharmacy? Can you ask your doctor what that code is? My pulmonologist is having a hard time figuring this out also.
lora jo

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@sueinmn

Walgreens. I have also used local independent pharmacies in Minnesota and Texas.
Sue

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Walgreens where I live says it isn't covered but is willing to apply the coupon so price around $11.00. However, there is a shortage and they won't even try to order it (the 3%). I would be happy to pay $11 but I have no choice but to order it from the manufacturer/supplier and pay about $42 (incl shipping) a month.

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@annagh

My local CVS, a very small pharmacy, tells me that since they don't dispense nebulizers or any other equipment covered under Part B, they can't (won't?) get coverage for my saline under Part B. Fortunately, my supplemental covers with a $10 copay.
Anna

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Anna - surprised that your Medicare (?) supplement covers when Part B doesn't. I always thought that Medigap only kicks after Medicare approval. I did not have much luck with CVS either, but only because they said they did not have ipratropium, which my doctor insists that had to be prescribed together with the sodium chloride. That turned out not to be true.

I should add that given all the different answers as to why coverage was denied it would be interesting to appeal and see what Medicare says officially.
Mary

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@sayaboleh

Anna - surprised that your Medicare (?) supplement covers when Part B doesn't. I always thought that Medigap only kicks after Medicare approval. I did not have much luck with CVS either, but only because they said they did not have ipratropium, which my doctor insists that had to be prescribed together with the sodium chloride. That turned out not to be true.

I should add that given all the different answers as to why coverage was denied it would be interesting to appeal and see what Medicare says officially.
Mary

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Perhaps because my supplemental isn't Medigap? It's the same policy from my husband's employment, continued into retirement. When we became eligible for Medicare we switched it to supplemental instead of primary.
Anna

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I recently wrote asking what pharmacies others have been able to find sodium chloride 7% vials for the nebulizer. I am having a hard time just finding pharmacies that are able to get it. I have tried Publix, Walgreens, Lincare, and CVS. I am waiting to see if CVS was able to find any and should know soon. I gave up on coverage by Medicare Part B and have been using GoodRx coupons, which make the vials quite reasonable, IF they are available. Please let me know where you have been able to get the vials. Thank you all! Donna T

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@donnaturn

I recently wrote asking what pharmacies others have been able to find sodium chloride 7% vials for the nebulizer. I am having a hard time just finding pharmacies that are able to get it. I have tried Publix, Walgreens, Lincare, and CVS. I am waiting to see if CVS was able to find any and should know soon. I gave up on coverage by Medicare Part B and have been using GoodRx coupons, which make the vials quite reasonable, IF they are available. Please let me know where you have been able to get the vials. Thank you all! Donna T

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Hi @donnaturn,
I have gotten my 7% saline at my Publix in Mt Pleasant, SC for several years now. They have only rarely had trouble acquiring it. Good luck!
Martha

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Thank you so much. I was just at our Publix on Wed. and was told it is not available. I will go back today and share your experience. Donna

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@marthamac

Hi @donnaturn,
I have gotten my 7% saline at my Publix in Mt Pleasant, SC for several years now. They have only rarely had trouble acquiring it. Good luck!
Martha

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Dear Martha,
I forgot to ask you if Publix will bill Medicare for you? My Publix pharmacy was successful with my Levalbuteral Rx, but not with saline. Thanks- Donna

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More reports of available 3% sodium chloride from major pharmacy locations would be really helpful. It might be that the solution could be shipped from maybe Walgreens or CVS? to one's house....so if someone gets 3% from a Walgreens or CVS somewhere it would be helpful to know which one where....thanks ahead of time.

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@donnaturn

Thank you so much. I was just at our Publix on Wed. and was told it is not available. I will go back today and share your experience. Donna

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Donna - When my Walgreens in Texas told me "still not available" last year, I asked them to CALL the distributor. Turns out it was available, but not from the small local distribution center. They had to send it from Dallas or San Antonio.
This year, no problem. Found out an acquaintance in our town was having issues this year at a different Walgreens - sent her to the other one and she got it.
Worth stopping in and asking the pharmacist to do a little more checking?
Sue

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@donnaturn

I recently wrote asking what pharmacies others have been able to find sodium chloride 7% vials for the nebulizer. I am having a hard time just finding pharmacies that are able to get it. I have tried Publix, Walgreens, Lincare, and CVS. I am waiting to see if CVS was able to find any and should know soon. I gave up on coverage by Medicare Part B and have been using GoodRx coupons, which make the vials quite reasonable, IF they are available. Please let me know where you have been able to get the vials. Thank you all! Donna T

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Donna - I've been having great difficulty as well finding the 7% - did the same. Called around everywhere and no one had it. I was also told that they could not even order it from their wholesaler until late Feb and even then there was no definite delivery date. One particular Walgreens told me that they had not been been to get it for months. I persisted and miraculously they finally found some (in the back of a closet?) .
I live in Northern California but it sounds like this is happening elsewhere as well. It is quite exhausting trying to find this and also figuring out how to get Medicare to cover it.
I actually called Nephron, one of the generic manufacturers and they admitted to a shortage on their end a few months ago which has been resolved. so who knows what's causing the supply chain problem.
Mary

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