FAQ

Home Infusion

What is infusion therapy?

Infusion therapy involves taking medications intravenously into the bloodstream, spinal cord or under the skin.

Infusion therapy is commonly used for: Antibiotics, Chemotherapy, Immune Globulin, Pain Management, and Parenteral Nutrition.

Conditions often requiring infusion therapy include: Cancer, Congestive Heart Failure, Gastrointestinal Disorders, Hormone Deficiencies, and Infections resistant to oral antibiotics.

What is the advantage of home infusion therapy?

Home infusion is a safe and effective alternative to inpatient care for many patients. National Pharmacy will perform a home assessment to guarantee that home infusion therapy is the appropriate method of treatment.

How do I receive your services?

If you or a family member is interested in receiving our services, please talk with your physician or health care provider or call 1-877-698-1551 (Toll Free) for more information.

Can I still work or go to school?

As long as your condition does not require you to be homebound, you will be able to maintain your normal lifestyle for the duration of your treatment.

What is a home infusion therapy provider?

A “closed door”, state-licensed pharmacy that specializes in providing infusion therapies to patients in their homes or other alternate-sites. The infusion therapy always originates with a prescription from a qualified physician who is overseeing the care of the patient.

Do government and private insurance plans cover infusion therapy in the home and other alternate-sites?

Nearly all commercial health plans treat home infusion therapy as a medical service, reimbursed under their medical benefit and paid for using a per diem for clinical services, supplies and equipment with separate payment for the drugs and nursing visits. Most commercial plans also require that infusion pharmacies be accredited. Commercial plans have used this model aggressively to reduce overall health care costs while achieving high levels of patient satisfaction.

Government health plans such as Medicaid, TRICARE, and the Federal Employees Health Benefits Program also reimburse for home infusion therapy, although for Medicaid in a few states the extent of coverage can have gaps.

Does Medicare cover home infusion therapy?

Unfortunately, Medicare’s free-for-service program is the only major health plan in the country that has not recognized the clear benefits of adequately covering provision of infusion therapies in a patient’s home. Because most Medicare beneficiaries are enrolled in the fee-for-service program, when seniors and the disabled find they may need infusion therapy they often find it unaffordable. National Pharmacy is familiar with Medicare’s coverage details and can advise prospective patients of their specific coverage and anticipated out-of-pocket obligations. 

Coverage under Medicare Part D:

While most infusion drugs may be covered by the Medicare Part D prescription drug benefit, the Centers for Medicare & Medicaid Services has determined that it does not have the authority to cover the infusion-related services, equipment and supplies under Part D.  

Coverage under Medicare Part B:

In Medicare Part B, there is some coverage for certain therapies administered using durable medical equipment. Unfortunately, only a select few therapies are covered and only under very specific conditions.  

Coverage under Medicare Part A:

For home nursing visits needed for beneficiaries receiving infusion therapy, there can be Medicare Part A coverage under Medicare’s home health benefit only if the patients are serviced by a Medicare-certified home health agency, as well as considered to be homebound and in need of intermittent (not 24 hour) home nursing.

Coverage under Medicare Part C:

A minority of the Medicare population is enrolled in the Medicare Advantage (Part C) program.  Similar to most commercial health plans, many Medicare Advantage health plans cover home infusion because they recognize it will reduce their overall health care costs and achieve high levels of patient satisfaction.

Who will infuse my medication?

A Home Health nurse, a caregiver, or even you may be the one to infuse the medication.  Our registered nurse will educate you on storage of the mixed medications, how to infuse them and proper flushing techniques for your IV access site.  Some insurances require the services of a Home Health agency to approve the infusion therapy.