How Much Does It Cost to Get an Iron Infusion

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You've been told you have iron deficiency anemia (IDA) - a common type of anemia. Or maybe your iron is too low and you're feeling dizzy. You've tried iron supplements by mouth, but now your healthcare professional recommends an iron infusion.

As with many medical treatments, the cost of an iron infusion can be a significant concern. Understanding the factors that influence the cost of an iron infusion can help you make informed decisions about your healthcare and potentially reduce your out-of-pocket expenses.

What is an iron infusion?

An iron infusion - or intravenous iron - is a treatment where extra iron is given directly into your bloodstream. It's typically recommended for people who can't take or aren't seeing progress with oral iron supplements. The goal of an iron infusion is to replace iron supplies that are missing in the body.

Iron is an essential mineral that helps you make hemoglobin - an important part of your red blood cells, which carry oxygen throughout your body. If your iron stores are low, you may have iron deficiency anemia. Even without anemia, low iron can lead to symptoms including dizziness, fatigue and headaches. In some cases, iron infusions may be needed to rebuild your iron levels quickly.

You may also need an iron infusion if you have:

• Certain cancers

• Chronic kidney disease (CKD)

• Heavy menstrual periods

• Inflammatory bowel disease

• A health condition that keeps your gut from absorbing iron properly

What's the average cost of an iron infusion?

There are different iron infusion products, and the cost varies based on the product and other factors. But in general, the cost of an iron infusion can range from $400 to more than $4,300 per infusion.

The most commonly used FDA-approved iron infusion products and their average cost, according to a 2017 Health Care Cost Institute (HCCI) report, include:

Types of iron infusions and their costs

Based on HCCI's report, Injectafer was the most expensive infusion, costing about 5 times as much as Venofer. Let's say a healthcare professional recommends 2 doses of Injectafer; your costs would be about $8,600. If your IDA reoccurs, you may need 2 more doses, at which point your total cost could quickly jump to over $17,000.

Generally, iron infusions are given in a medical office, outpatient infusion center, or at home. Although they're medications, iron infusions are usually covered under your medical benefits, not your prescription benefits.

What factors affect how much you'll pay for an iron infusion?

The amount you pay for an iron infusion depends on whether you have health insurance and what your benefits cover. Most health plans will cover the cost of an iron infusion if it's prescribed by a healthcare professional and is medically necessary.

However, depending on the iron product used and the overall bill, your out-of-pocket expenses may vary significantly. For example, your portion of the cost may depend on whether you have a deductible, coinsurance, or a set copay per treatment.

Other factors that may affect how much you'll pay for an iron infusion include:

• Where you receive the infusion: You may pay more if you receive an infusion at a hospital or outpatient center instead of a healthcare professional's office. This is because hospitals and outpatient centers typically have added fees and may charge significantly more.

• Where you live: The cost of an iron infusion may differ depending on the area of the country in which you live and receive your care.

• Generic vs. brand-name: Some approved iron infusions have a generic version. Often, the generic can help you save on treatment costs while giving you the same health benefits.

• Office visit fees/laboratory charges: In addition to office visit fees, you'll likely face additional charges for blood tests to confirm an IDA diagnosis. After your infusion, your prescriber will generally want to do more blood tests to check if your iron levels have improved.

• Repeated doses: If your iron levels have not normalized or your symptoms have not improved, your prescriber may recommend additional doses of iron infusions, which may drive up your out-of-pocket costs.

Does Medicare cover the cost of an iron infusion?

Medicare Part B covers 80% of the approved amount for an iron infusion if you meet qualifying conditions. For example, Medicare covers certain iron infusion treatments for people with iron deficiency anemia who are on long-term hemodialysis and receiving erythropoietin therapy. Specifically, Medicare covers sodium ferric gluconate (Ferrlecit) and iron sucrose (Venofer) infusions as the primary treatments in these situations. This means that you will generally be responsible for any Part B deductible amount plus 20% coinsurance.

Iron infusions may also be covered by Medicare for people with iron deficiency anemia if oral therapy is not tolerated or effective.

Medicare Part B also covers home infusion therapy. This Medicare benefit is part of the 21st Century Cures Act and covers 80% of home infusion services, including supplies and nursing visits.

Can supplemental insurance help cover iron infusion costs?

Medigap and Medicare Advantage plans can reduce your out-of-pocket expenses.

Medigap policies generally pay your share of the bill that Medicare doesn't cover, such as the 20% coinsurance and, in some cases, your deductible. They follow Medicare's guidelines, so if Medicare covers a service - including iron infusion - a Medigap plan would cover the same.

Most Medicare Advantage plans cover iron infusions, since they are required to cover at least what Medicare Parts A and B cover. The specific coverage benefits vary depending on the insurance company and your policy.

Are there any alternatives to an iron infusion?

Yes. If you have IDA, a healthcare professional may first recommend taking iron supplements by mouth. This is the most common treatment for iron deficiency, and most iron pills are available over the counter. Oral iron pills can take several weeks to months to rebuild your iron levels, and not everyone can tolerate them.

You may also eat iron-rich foods to help prevent IDA, but they're not always effective at treating the condition.

How much does an iron infusion cost without health insurance?

Without health insurance, you'll pay the full cost. In addition to the medication's cost - which may be marked up - expect to pay an infusion administration fee based on the length of each infusion. You might also have to pay extra for blood tests or other services to check your iron levels and make sure the treatment is working.

It's important to do your research and ask questions about the product they use and their process to get a better idea of costs.

How to save on iron infusion cost

Many iron infusion manufacturers offer patient financial assistance programs that can help cover some or all of the cost. For example, you can pay as little as $50 for a dose of Injectafer using the manufacturer's savings program.

Other options include setting up a payment plan directly with the facility or healthcare professional, or using a medical credit card such as CareCredit. If you're considering loan options, it's important to compare the interest rates and finance terms of the different offers to keep the amount you pay over the life of the loan as low as possible.

Are iron infusions worth the cost?

If left untreated, IDA may cause serious health issues, such as:

• Heart problems

• Weakened immune system

• Pregnancy complications

• Delayed growth in children

To help determine if iron infusions are worth the cost, discuss your health condition, the health benefits of iron infusions, and other treatment options with your prescriber.

Here are 10 questions you should ask to help you and your prescriber decide the best, most cost-effective treatment for you:

• What iron infusion product is being prescribed?

• Is there a less expensive iron product appropriate for my condition?

• How many infusions will I need?

• How long is each infusion (a 1-hour infusion may cost less than a 2-hour infusion)?

• How much are the professional or facility fees?

• Are patient financial assistance programs available?

• Will I receive a good faith estimate if I pay the bill myself?

• If I use insurance, will I receive an estimate of my expected financial responsibility before the infusion?

• Is the healthcare professional or facility part of my insurance network?

• Is a prior authorization required?

If you have insurance, it's a good idea to call your insurance carrier to verify if the healthcare professional or facility is in your network and how this might impact your cost. Also, verify the benefit details and medical necessity criteria for the prescribed iron product.

Some health plans will also provide you with the allowable amount (the most they will pay for a service) before you receive the infusion. These answers will help you determine your expected portion of the cost and make an informed decision while getting the quality of care you need.

Frequently asked questions

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