I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis - NxStage Users => Topic started by: vcarmody on October 26, 2010, 11:01:14 AM
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After going back and forth for months I finally got the call last night that they are going to allow me to give my husband his Epogen injections at home. :bandance; I finally sent an email to the corporate office after being denied by the center because they said if they gave it to me to do at home they would need a pharmaceutical license. I question how they could give me heparin which is also a prescription drug but not be able to give me Epogen. I really didn't get a very good response. I tried getting it through our prescription plan but they wanted a co pay of 100.00 a month. I then asked again why it couldn't be sent home like the other supplies. They said it was a company policy. I checked with my husbands private insurance (BC/BS) to make sure it was covered, I was advised it is covered because they had to follow the guidelines Medicare put out and one of the rules was that Epogen can be administered at home. I took this information and wrote an email to the corporate office on Friday. Our nurse at the center called yesterday and they said it was feasible for me to give it at home, so tomorrow I go for training on administering it!!! :clap; My husband is happy cause now that the bad weather is coming he don't have to worry about going out in the cold, snow and ice to get his shot. :yahoo;
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I had to go on epo for a while, and I was told by bcbs that it would be covered but that I had to do it at home...they'd pay for the drug but not for someone to give me the shot, so I am really confused about why this has been such a problem for you. I DIDN"T want to self-administer for reasons I won't go into here, so my neph's PA told me she'd give it to me but that I would have to pay $10 for the privilege. It seems that you and I have been told exactly the opposite things. Geez, no one even said anything to me about teaching me how to self inject or anything. You know, I think bureaucrats just make this crap up, I really do. There's some moron in the corner office who gets paid to think up how many rules and restrictions will apply...$10 a rule.
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I've always done my own shots. The first 2-3yrs on dialysis it was EPO. They gave me 2-3bottles (depending on dose) and syringes. I would do my weekely shots.
Then they switched to Aranesp. So for the last 3+yrs I've been given aranesp pre-filled syringes to bring home and do my own shots.
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MooseMom, our nurse was always for us being able to do it at home. The NO always came from someone that heads the clinic. Honestly, this person seems to set the rules and everyone that works there seems to either be afraid of her, or think she knows everything because she ran another clinic before and accepts everything she tells them. When I read on here most Nxstage users did there own shots at home that is when I really started pushing. I had the same problem when I wanted a dialysis chair. They said we had to get our own. So I tried to find a dialysis chair and no one would sell me one. They only sell to clinics. So in my search to find a chair, I posted on here asking if anyone knew where I may be able to get a real dialysis chair, not a Geri chair and the response from most was that there clinics supplied them. After research I found that it is part of the Medicare bundling and if they don't supply the chair they are not supposed to get paid for any of the set up cost. So again I contacted my insurance only to find out that yes they do cover it. The clinic still would not help me in my search for one. So I ended up buying just a regular recliner. My husbands access is in his right arm so we had to buy an electric one because he was unable to put the feet up and down with the handle, almost $600.00 dollars later I have a chair we use only for his dialysis and it can not go into the head down position and I can not get insurance to pay for it. I though about submitting the bill to them and asking for reimbursement, but I figure then they would just give an old used chair from the clinic and say were even. I think they probably think I am a bitch, but honestly I only want what is best for my husband, I figure his insurance pays through the roof (over 20,000.00 a month) for his treatments that I do at home, he deserves to be as safe and comfortable as possible.
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I have given my self epo shots even before I started D...... I just wish they would let us give our selves Iron too at home..... seems so petty that we can give some things and yet not others...... I think its all about the botton line....MONEY...... and how they can save them selves a butt load...
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vcarmody, it seems that it would be a good idea to question any and everything your clinic tells you. Sounds like you have a bit of a power freak at its head. Let's face it...there are some people in the world who just make up whatever rules they want simply because they can.
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whats kind of funny about the epo shots is that *pre* dialysis, bo (hubby) was getting the bottles to bring home and do himself. There was the 'co' pay for the drug. Then, one day while paying, the lady next to us told us that if we went IN to the nurse clinic, it was free :o So, we went in and for that year, free! Now im wondering what it'll be for us when we start our home D. Always something huh.. ::) oh, and we too were told no chair. Wonder if it's something we should question as well..hum
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I had to go on epo for a while, and I was told by bcbs that it would be covered but that I had to do it at home...they'd pay for the drug but not for someone to give me the shot, so I am really confused about why this has been such a problem for you. I DIDN"T want to self-administer for reasons I won't go into here, so my neph's PA told me she'd give it to me but that I would have to pay $10 for the privilege. It seems that you and I have been told exactly the opposite things. Geez, no one even said anything to me about teaching me how to self inject or anything. You know, I think bureaucrats just make this crap up, I really do. There's some moron in the corner office who gets paid to think up how many rules and restrictions will apply...$10 a rule.
That has got to be in my top 10 of the most stupid things insurance companies say/do. I hope they don't take that to a higher level and say "We'll pay to take the kidney out of the donor, but we won't pay to put it inside you. Have a nice day". That's just stupid!!!!
@vcarmody, congrats on getting the authorization to do the injections at home. Any reason to not make the drive to the doctor's office would be a plus in my book. :2thumbsup;