Medicare Announces Expanded Coverage For Warfarin Patients Monitoring Clotting Time At Home

March 20, 2008 8:20 AM CT

For any of us that have suffered the vagaries of being on Warfarin/Coumadin®, this is huge news. Hopefully it will open the door for more insurance companies covering this as well.

From Medical News Today:

Medicare Part B will now cover and pay for meter training, equipment and supplies for all long-term warfarin users who monitor their prothrombin time at home with a portable handheld meter. The change opens the door to greater convenience and potentially fewer complications for a broader spectrum of anticoagulation patients. Medicare previously reimbursed these expenses only for patient self-testers who had mechanical heart valves. The new coverage expands to include those on anticoagulant medication with chronic atrial fibrillation and venous thromboembolism.

Portable, handheld prothombin time (PT/INR) meters enable patients to test their clotting time at home in about a minute, using a small drop of blood from a simple fingerstick.

Studies suggest that anticoagulation patients who self-test may experience fewer complications overall than those who do not, because self-testing may increase patient time in therapeutic range. Studies also suggest that PT/INR self-testing (performed with a blood sample from a fingerstick) is just as accurate as fingerstick testing performed by a healthcare professional and conventional testing performed on a laboratory analyzer.

Under the new Medicare B policy, the patient portion of costs for self-testing is expected to be about $30 a month (based on a national average) for the use of a PT/INR meter and test strips, and about $35 for the initial training. Patients with supplemental insurance coverage could potentially have little or no out-of-pocket expenses.

All patients on anticoagulant medication need a prescription from their doctor for a self-testing meter and supplies before being able to monitor their own clotting time at home. Patient self-testing is also designed to augment, not eliminate, testing and therapy management that is overseen by a doctor. Patients who self-test notify their doctors of clotting time results so they can make the proper adjustments to medication.

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