That is so weird. The only 7% that turned up when I searched Amazon just before I posted was Neveh, which I don't recall seeing before. Now the 7% Base is available, too. I'm glad it is, but I had looked for it. I'm wondering if ReRE ran into similar glitch or temporary outage and we just need to check again if our supplies don't show up at first. I haven't been ordering it that long.
That is so weird. The only 7% that turned up when I searched Amazon just before I posted was Neveh, which I don't recall seeing before. Now the 7% Base is available, too. I'm glad it is, but I had looked for it. I'm wondering if ReRE ran into similar glitch or temporary outage and we just need to check again if our supplies don't show up at first. I haven't been ordering it that long.
It's been my experience with a lot of things that medical supplies are up and down, especially scarce items like 7% saline. I have also had issues getting a consistent supply of certain wound dressings.
Base labs 7% saline 50 vials is currently on sale on their site for $39.99. If you buy more than you need for short-term use, just refrigerate it like they do in the hospital.
My insurance covers the 7% saline. A prescription is needed. I hear most insurance companies do not pay for. I have Humana PPO Medicare Advantage. I get it at Walmart.
Let's start with this - technically a prescription is not required to by normal or hypertonic saline solution. Based on this, most insurers, including Medicare will not allow you to use prescription benefits to pay for it. I KNOW - sometimes pharmacist and insurers let it "slip through" but they aren't required to.
Long story on Part B, but here goes (and I'm going to immediately repost to the ABC's of MAC & Bronchiectasis so I can point to it later.This was not my idea, and I wouldn't even begin to guess the logic, but here it is in a nutshell.
1) Any solution used in a nebulizer, or other piece of "durable medical equipment", is not covered by Part D Medicare but MAY be covered by Part B Medicare (other medical expenses) under certain conditions. Usually these are explained in long documents issued by Medicare.
2) Hypertonic saline (any solution above .9%) falls into this category.
3) The limitations, as I understand them are this: you must have been prescribed a nebulizer by Medicare for dispensing a prescription solution (other than saline.) Some plans also require that those prescription solutions are currently being dispensed. Silly thing - if I get my saline and levalbuterol at the same time, I pay $5, other wise my copay is around $15.
4) The pharmacy where you buy the saline must have a Part B contract with Medicare. Some chains dispense durable medical equipment and have such agreements, others do not (CVS in our area does not, but Walgreens and Walmart do.)
5) The pharmacy must submit the claim to Medicare Part B with the appropriate codes. And they must indicate on the initial prescription that you have a Medicare prescribed nebulizer. Please don't ask - I don't know them and cannot get them. Your copay will be reduced according to you Part B Medicare and any supplemental insurance you have, so you may pay 20% of retail, or 20% of the "allowable amount" or even zero under some plans.
If you are having issues with coverage, please reread. If you meet the requirements, consider checking with another pharmacy. Ande be sure to check out GoodRx.
Thanks for all the info. I nebulizer with 7% in 4ml vials twice a day. I get my pulmonologist to write a prescription for a three month supply - which equates to 180 vials (2/day times 90). The prescription MUST be written for 720ml (4ml times 180 vials = 720ml). This costs me under $50 for three month supply at Shaws or at my university pharmacy. It can be even cheaper at other places with good RX however, my local Price Chopper and CVS, etc. can’t get the 7%. I am curious if anyone knows how we can fight for this lifelong medication to be covered by insurance? I would be willing to work on this if I had any clue about how.
Thanks for all the info. I nebulizer with 7% in 4ml vials twice a day. I get my pulmonologist to write a prescription for a three month supply - which equates to 180 vials (2/day times 90). The prescription MUST be written for 720ml (4ml times 180 vials = 720ml). This costs me under $50 for three month supply at Shaws or at my university pharmacy. It can be even cheaper at other places with good RX however, my local Price Chopper and CVS, etc. can’t get the 7%. I am curious if anyone knows how we can fight for this lifelong medication to be covered by insurance? I would be willing to work on this if I had any clue about how.
If CVS and Price Chopper do not handle durable medical equipment, there is nothing we can do under current regs. This is not an indictment - many grocery retailers have entered the Rx market as a convenience to their customers, but we need to recognize that they are here to serve the majority, and we are a very small minority. When we have local options, it may be inconvenient, but we can live with it. Given the complexities of modern medicine, not every pharmacy can serve every customer. For example, all of my meds can be ordered from my local supermarket pharmacy, except my one biologic. The head pharmacist explained that they would need to have special paperwork, refrigeration and inspections that the potential volume did not justify.
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That is so weird. The only 7% that turned up when I searched Amazon just before I posted was Neveh, which I don't recall seeing before. Now the 7% Base is available, too. I'm glad it is, but I had looked for it. I'm wondering if ReRE ran into similar glitch or temporary outage and we just need to check again if our supplies don't show up at first. I haven't been ordering it that long.
It's been my experience with a lot of things that medical supplies are up and down, especially scarce items like 7% saline. I have also had issues getting a consistent supply of certain wound dressings.
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1 ReactionHi Sue,
Flo here @frankie160
Do I understand that Sodium Cholride Hypertonic Saline 3% is not covered by Prescription D
If so, why not?
Thanks,
Flo
My insurance covers the 7% saline. A prescription is needed. I hear most insurance companies do not pay for. I have Humana PPO Medicare Advantage. I get it at Walmart.
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2 ReactionsI often purchase online from Nebology.com. Sometimes they have sales on their products.
You can currently use a Good Rx coupon at Walgreens and hey 60 vials for 10.28.
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5 ReactionsThank you!
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2 ReactionsFlo and everyone - this is a perennial question.
Let's start with this - technically a prescription is not required to by normal or hypertonic saline solution. Based on this, most insurers, including Medicare will not allow you to use prescription benefits to pay for it. I KNOW - sometimes pharmacist and insurers let it "slip through" but they aren't required to.
Long story on Part B, but here goes (and I'm going to immediately repost to the ABC's of MAC & Bronchiectasis so I can point to it later.This was not my idea, and I wouldn't even begin to guess the logic, but here it is in a nutshell.
1) Any solution used in a nebulizer, or other piece of "durable medical equipment", is not covered by Part D Medicare but MAY be covered by Part B Medicare (other medical expenses) under certain conditions. Usually these are explained in long documents issued by Medicare.
2) Hypertonic saline (any solution above .9%) falls into this category.
3) The limitations, as I understand them are this: you must have been prescribed a nebulizer by Medicare for dispensing a prescription solution (other than saline.) Some plans also require that those prescription solutions are currently being dispensed. Silly thing - if I get my saline and levalbuterol at the same time, I pay $5, other wise my copay is around $15.
4) The pharmacy where you buy the saline must have a Part B contract with Medicare. Some chains dispense durable medical equipment and have such agreements, others do not (CVS in our area does not, but Walgreens and Walmart do.)
5) The pharmacy must submit the claim to Medicare Part B with the appropriate codes. And they must indicate on the initial prescription that you have a Medicare prescribed nebulizer. Please don't ask - I don't know them and cannot get them. Your copay will be reduced according to you Part B Medicare and any supplemental insurance you have, so you may pay 20% of retail, or 20% of the "allowable amount" or even zero under some plans.
If you are having issues with coverage, please reread. If you meet the requirements, consider checking with another pharmacy. Ande be sure to check out GoodRx.
Thanks for all the info. I nebulizer with 7% in 4ml vials twice a day. I get my pulmonologist to write a prescription for a three month supply - which equates to 180 vials (2/day times 90). The prescription MUST be written for 720ml (4ml times 180 vials = 720ml). This costs me under $50 for three month supply at Shaws or at my university pharmacy. It can be even cheaper at other places with good RX however, my local Price Chopper and CVS, etc. can’t get the 7%. I am curious if anyone knows how we can fight for this lifelong medication to be covered by insurance? I would be willing to work on this if I had any clue about how.
If CVS and Price Chopper do not handle durable medical equipment, there is nothing we can do under current regs. This is not an indictment - many grocery retailers have entered the Rx market as a convenience to their customers, but we need to recognize that they are here to serve the majority, and we are a very small minority. When we have local options, it may be inconvenient, but we can live with it. Given the complexities of modern medicine, not every pharmacy can serve every customer. For example, all of my meds can be ordered from my local supermarket pharmacy, except my one biologic. The head pharmacist explained that they would need to have special paperwork, refrigeration and inspections that the potential volume did not justify.