Procrit and Medicare

[lynne]

I have heard that once I turn 65,and am on Medicare that Medicare will not pay for my Procrit injections. I am on Kaiser Permanente now,and they pay until if/when my hemoglobin gets to 12. What does anyone know about Medicare paying for Procrit?

[Terri]

As far as I know I thought Medicare would pay as long as HGB under 12 as well.
Did you check with your Doctors office???

[Jimbob]

I believe that Terri is correct bbut to relieve any unneccessary anxiety you can get a very specific answer directly from Medicare by calling 1-900-MEDICARE.

[Neil]

Medicare will pay for Procrit as long as it is given in a docs office and your HCT is 35 or lower ( might be 37 can’t recall exactly, but it is on the chart that accompanies the drug in your file, a yellow/orange page).
If you have a supplement it will probably pick up the portion medicare does not cover.
There is a charge for the injection, the CBC and the cost of the Procrit.
The Procrit is covered under Medicare Part B, so a supplement will usually pick up the uncovered balance, depending upon which supplement you have and the coverage. BCBS Senior Gold does cover it—in Minnesota.
Medicare Part D is not involved(as long as the injection is given in the docs office).

[Jim]

I agree with Neil. I’m 66 and Medicare has been paying for my Aranesp, injection and CBC as long as Hgb is under 12. I have had all the shots at the hospital cancer center.

[diner]

Yes, Medicare pays but they won’t if the patient gives his own shot. Dee

[Author]

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