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Medicare Part B payment for 7% sodium chloride vials

In: General Discussion
13 2637
M

I have been trying unsuccessfully for months to arrange a way for Medicare Part B to pay for the 7% sodium chloride in 4ml vials that I use twice daily through a prescribed nebulizer to treat Bronchiectasis. I have consulted with my pulmonologist, pharmacist, Medicare directly and even a respiratory specialty hospital. Everyone says that this should be covered but has not been able to provide specific information to make it happen. Can anyone help?

Latest Activity: December 17, 2023
10
13 Replies

Replies

K

MKB,

Hello! Can you try a different pharmacy? I know this may sound too easy but some pharmacies assist you more in getting your prescriptions than others.

Latest Activity: March 29, 2023
5
K

I can't get my 7% saine covered either I think its all medicare. They won't pay for my zertec anymore wth script from the dr also. I alternate with the salne and mucomyst which Medicare will cover.

Latest Activity: March 29, 2023
4
M

Hi, MKB! This appears to be something of a common problem. I've seen many conflicting reports where some people can get it, some can only get it with great difficulty, and others can't get it at all.

According to the Cystic Fibrosis Foundation, hypertonic saline is not covered because it is technically not an FDA-approved medication. It looks like it is approved for diagnostic purposes in some parts of the country, so that may be where some of the confusion comes from. Some people seem to also have some success having their health care professional negotiate with a local pharmacy. Finally, there are websites that can provide discounts for certain meds. For example, I searched for 7% sodium chloride vials in my area on GoodRx, and found a coupon that lowered the price from $55 to $20. Prices may be different in your area, of course.

I'm sorry I don't have better news, but it seems like it's going to be a complicated process with uncertain results. Please keep us posted as you work through it!

Latest Activity: March 29, 2023
6

Comments

K

Hi Mike yes I have to pay $55.00 for the saline.  Used to be 30.00  

Latest Activity: March 30, 2023
K

Mike,

Thank you for the update and resources.

Latest Activity: March 29, 2023
7
A

Try Amazon Pharmacy.

Latest Activity: June 23, 2023
3
K

Mine hasn't ever been covered either by Medicare. I used to pay for two boxes $30.00 that went to $55.00.

Latest Activity: June 24, 2023
6
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023
J

Did you file a claim with medicare to get an exception to their policy, so that you do get coverage for the saline solution?  I was thinking of doing that (like for a few years now...just haven't gotten to it).  

Latest Activity: December 17, 2023

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