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Regaining your health with Inflammation Therapy (IT) is priceless but some patients with limited financial resources wonder if they can afford it. Many patients found that they have spent far less on IT than their previous healthcare costs. You won't be buying supplements, undergoing many diagnostic tests or taking IV medication. If cost is an issue, let your doctor know so you can discuss ways of minimizing the expenses.

 
 
Inflammation Therapy expenses involve:
  • clinic visits
  • lab tests
  • medication
  • sunglasses
Some of these costs are covered by insurance. You can check your coverage before you agree to a visit, test or medication so that you are aware of the potential cost. In the USA, insurance coverage varies widely. Many members obtain full insurance coverage.
 
Clinic visits
 
This cost is dependent on the amount the clinic charges and how often your doctor wishes to see you. You could ask if you can cut costs by minimizing clinic visits. Many doctors will allow you to keep in touch via email. If you need to travel some distance to see your doctor, s/he will often keep follow-up visits to a minimum.
 
Lab tests
 
Usually, the D-Metabolites tests are covered by insurance without question when using the codes listed. If cost is an issue, you can forgo the 1,25-D test (which is the more expensive of the two) if your doctor does not require it. You will need to test 25-D and then will need to measure it regularly. For details, see D-Metabolites Tests
 
Other routine lab tests or chest x-rays may be needed as determined by your doctor to monitor your progress and should be covered by insurance. If you are not insured, ask your doctor to perform only those tests that are essential.
 
Some doctors order an expensive panel of tests routinely on new patients. This is not part of Inflammation Therapy and you should respectfully question the need for any test before you agree to it.
 
Medication
 
Benicar® is the backbone of IT and will be continued throughout the treatment which often lasts several years. If you have a medication benefit to your insurance policy, including Medicare and Medicaid, you may have to file an appeal to obtain full coverage of the recommended dose of Benicar®. See Insurance Coverage for Inflammation Therapy.
 
If you must pay for Benicar® out-of-pocket, this will probably be your largest expense. There is information on countries where Benicar® is sold, the least expensive sources and programs for low income patients in Benicar®.
 
The cost of the low dose oral inflammation antibiotics is not extravagant. Insurance plans usually cover the costs of antibiotics without question.




 
Sunglasses
Appropriate sunglasses are essential. A basic purchase would be 2 pairs of NoIR sunglasses (10% and 2%) which retail for around $40 each. See Sunglasses.

Access to our extensive, easy-to-read Library of Information (see this sample page) is available to patients without enrollment in our counseling program. Interested patients should send a request along with their doctor’s name and fax number or email address to This email address is being protected from spambots. You need JavaScript enabled to view it..

Insurance coverage of Inflammation Therapy

In the USA, private, federally –funded and state-funded insurance coverage varies widely.

If your doctor accepts insurance, clinic visits are usually covered by most insurance plans with the usual deductible and co-pay stipulations. Clinic visits usually don’t need to be frequent during Inflammation Therapy (IT), especially if you enroll in the CIR counseling program.

Routine lab tests to monitor organ function are usually covered by insurance with the usual deductible and co-pay stipulations. The Vitamin D tests have been covered without question when using the correct codes. Other tests (e.g., x-ray, CT scan, MRI, etc) can add significant expense to treatment, even if covered by insurance. Let your doctor know if cost is an issue so you can discuss which tests are essential and which can be omitted or done less often.

Insurance plans don’t cover the cost of NoIR or the other recommended sunglasses.

Most IT patients find that the therapy antibiotics are covered by their health insurance. They can be ordered at the standard dosage and schedule without question to maximize your insurance benefit.

It isn’t unusual for an insurer to initially deny payment for the increased cost of the required dosage of Benicar®. Patients who are denied coverage for the dose of Benicar® that IT requires have the right to appeal that decision. Your physician or other health care practitioner may need to write a “Letter of Medical Necessity” to the insurance company in order to help the patient obtain needed coverage.

If all attempts to obtain insurance coverage for the recommended IT Benicar® dosing fail, you can accept the lower level of coverage and pay out-of-pocket for the rest. 

 

 

For more insurance information, please see:

Insurance Coverage for Inflammation Therapy