About Infusion Treatment Centers and Your Out-of-Pocket Costs

If you use an infusion drug (given through an I.V.), there may be some ways you can save money. What you pay can depend on where you go to get the drug infusion.

Infusion Drug Care Costs

Infusion drugs that must be given to you by a health care provider are often covered under your medical benefits rather than your pharmacy benefits. In most cases these drugs can be safely given to you at a non-hospital setting, such as:

  • A doctor’s office
  • A stand-alone infusion center
  • Your home, through home health care

If you and your doctor choose to get your infusion drug care at an outpatient facility instead of an inpatient hospital setting, you may lower your out-of-pocket cost.

Preferred Infusion Locations

These hospital outpatient infusion locations are covered by your health plan at a lower cost to you.

Rural Outpatient Facilities

Chicagoland Outpatient Facilities

About Your Infusion Drug Benefits

Como siempre, a las decisiones sobre el tratamiento las toman usted y su médico. You should talk to your doctor about where to go for infusion treatment. If you are getting care now, find out if changing your treatment location is right for you.

If you and your doctor decide to keep your treatments in a hospital, rather than an outpatient setting, you may pay more for your treatments. 

Your doctor will also need to get prior authorization (or pre-approval) before treatment to avoid unexpected costs. Once approved, you will pay your share for the cost of the drug, based on your health plan.

 

Coverage is based on the terms and limits of your benefit plan. Not all plans may provide out-of-network benefits. For plans that have a deductible, the out-of-pocket costs are separate. Your out-of-pocket costs for certain provider settings also may not count toward your plan's total out-of-pocket amounts. These out-of-pocket costs can be up to the full cost of the drug and/or the fee for your health care provider to give it to you, based on your benefit plan. Vea los materiales informativos de su cobertura para obtener más información.

 

Última actualización: 12 de junio de 2023