Saline Solution Vital to Health: Medicare Negates

@pawster According to Medicare logic (not mine) any substance dispensed by a piece of durable medical equipment, covered under Part B Medicare, also falls under Part B, Medical, not under Part D , Prescription Medication.
Saline is covered, along with nebulized solutions. I don't have access to my previous messages right now, but there is a document that explains the codesmwhich must be used, then it is covered 80%. Look at the 7% saline discussion to find the link. It is all in how the doctor codes it. Because my supplement covers my 20%, when the pharmacy codes it correctly my copay is minimal.
The people at Medicare explained that it falls into the same class as saline used to flush IV PICC lines, and is classed as a supply for durable medical equipment.

If you ever helped draft Federal Regulations, as I did in my career, nothing would surprise you. The underlying rules, which have evolved over 100 years, are arcane and incomprehensible. Then the public gets to comment, and the lawyers get to emend. The end result is always a surprise to those who do the initial draft.
Sue

@sueinmn Sue-- I tried to find the "7% saline discussion to find the link" but without success.
Questions:
Are you still able to secure your saline for nebulizing with Original Medicare and the Supplement?
Do I understand fully ....the saline which is to flush the IV PICC lines is the same saline we need for nebulizing.... and that the doctor needs to order it in 4ml 7% if that is what one is to use for a patients BE treatment.??
Does that saline come stating Hypertonic or Sodium Chloride saline?
My last order has a $60.00 price tag vs the orders before were either four dollars and change, and then jumped to ten dollars in change. Going to $60.00 is a big difference.
Barbara

@blm1007blm1007 I haven't needed to order saline yet in 2026, so I can't answer you. My Rx supplies 60 vials per month and I only use about 5-10, so have quite a stockpile.
As to whether there is a shortage, I'll ask my local independent pharmacist next time I call to refill prescriptions.

@sueinmn Are you thinking there is a shortage is why I was given a $60.00 price?

Help.....Do I understand fully ....the saline which is to flush the IV PICC lines is the same saline we need for nebulizing for our BE.... which means the doctor needs to order it in 4ml 7% (the saline used for the flush PICC line) to use for a patients BE treatment.?? I can't imagine that it isn't the same?????
Does that saline for flushing the IV PICC lines come stating Hypertonic or Sodium Chloride saline? From what little I know I have a feeling it comes in a box saying Hypertonic Saline Solution???
Thanks, Sue
Barbara
P.S. I just happen to go to SPAM, which I rarely do, and found your answer there....Lesson learned...open spam each day.

@blm1007blm1007 No, I don't think there is a shortage, although there was a temporary one a few years ago. I think $60 is the retail price. It sounds like either your insurance or Medicare quit covering the saline, so you are being charged the full price now.
PICC lines are flushed with normal saline (0.9%), not hypertonic (7%) - and when my friend needed it, it was supplied in pre-loaded syringes, not the vials like we use.
Saline in 4-5 ml vials is sometimes used to mix with and dilute meds for nebulizing, but that is usually normal saline as well.

@sueinmn Are you thinking there is a shortage is why I was given a $60.00 price?

Help.....Do I understand fully ....the saline which is to flush the IV PICC lines is the same saline we need for nebulizing for our BE.... which means the doctor needs to order it in 4ml 7% (the saline used for the flush PICC line) to use for a patients BE treatment.?? I can't imagine that it isn't the same?????
Does that saline for flushing the IV PICC lines come stating Hypertonic or Sodium Chloride saline? From what little I know I have a feeling it comes in a box saying Hypertonic Saline Solution???
Thanks, Sue
Barbara
P.S. I just happen to go to SPAM, which I rarely do, and found your answer there....Lesson learned...open spam each day.

@blm1007blm1007
I can get the saline at Walgreens for 10 dollars using GoodRx coupon.

@blm1007blm1007 No, I don't think there is a shortage, although there was a temporary one a few years ago. I think $60 is the retail price. It sounds like either your insurance or Medicare quit covering the saline, so you are being charged the full price now.
PICC lines are flushed with normal saline (0.9%), not hypertonic (7%) - and when my friend needed it, it was supplied in pre-loaded syringes, not the vials like we use.
Saline in 4-5 ml vials is sometimes used to mix with and dilute meds for nebulizing, but that is usually normal saline as well.

@rmason Did you just start using the saline for nebulizing this year or have you been on it for a couple of years?

I'm trying to figure out if it is possibly due to my insurance, as Sue mentioned if possibly might be why, or Rx or Walgreens not giving me the lesser price?
Barbara