The reason for this question is the current RX carrier is refusing to cover the script because of the "Immunizations Agents or Biological Sera" exclusion in the Plan description.
It is an immuneglobulin. Are they nuts. Its for immune deficiency. Its not an immunizing agent. Unfortunately it is made from biological sera. The way I see it they can either pay for it, or for all the diseases you catch because your immune system is low. If you go to this website, you can see if you qualify for assistance from the manufacturer www.hizentra.com/igiq-support-services/patient-assistance.aspx
I have been getting Hizentra for about 3 years now, but have been on IgG infusions for 9+ years. I have been through the insurance red tape you are experiencing now. Hizentra is a blood product. It takes the blood from 1000+ donors to make this. It falls under Specialty Rx with nearly all prescription insurances. If they still won't cover it, you can always go to the doctors office weekly and let the nurses do the infusion. It would then be covered under your major medical rather than prescription plan. I will add you as a friend and if I can help with any of your questions, you can send me a private question. Best wishes. Don't give up on this.
P.S. Hizentra is manufactured by CSL Behring. They have what they call the "Assurance Plan". With that, for every 3 months that you get Hizentra, they will provide, free of charge, 1 month of Hizentra, should you lose your insurance, or if it changes. I don't know if they can help you if you have insurance that just won't pay for it, but it doesn't hurt to ask.
- Hizentra Information for Consumers
- Hizentra Information for Healthcare Professionals (includes dosage details)
- Side Effects of Hizentra (detailed)
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