Most long-term Coumadin® users qualify for INR home monitoring coverage through Medicare.
Medicare patients that meet the following conditions are eligible for home monitoring:
- The patient must have been anticoagulated for at least 3 months prior to use of the home INR device;
- The patient must undergo a face-to-face educational program on anticoagulation management and must have demonstrated the correct use of the device prior to its use in the home;
- The patient continues to correctly use the device in the context of the management of the anticoagulation therapy following the initiation of home monitoring;
- Self-testing with the device should not occur more frequently than once a week.
- Have one of the following Diagnosis (See ACS’ prescription form for all approved Diagnosis Codes for home INR testing)
- Mechanical Heart Valve
- Chronic Atrial Fibrillation
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Hypercoagulable State
The majority of patients with private insurance qualify for home monitoring. Each health plan is different, and some may require a prior authorization before approving services, regardless of the patient’s diagnosis. Advanced Cardio Services is contracted with Blue Shield, Humana, Coventry National, and other insurances for our home INR testing service.