Self testing INR in the United States-Has anyone had any luck getting self testing machines that are covered by Medicare

I live in NYC-Manhattan and have had intravenous INR testing and now quick stick testing. I was on vacation (two hours from home in New Jersey) and hospitalized because( for a reason no one knows) I started bleeding-gross hematuria -with an INR of 13.6 (unbelievable) My levels were stable for over a year in the 3's with slight variations.

Has anyone in the US gotten approval and had luck with self-testing. I'm now trying to get an appointment with Dr. Erkan at the Hospital for Special Surgery who I learned about on this site.

I'm on Medicare. Thank you again for your continued help.

Loretta

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  • Hi!

    Got Roche CoaguChek in May paid for by Medicare. Am allowed to test, so far, once a week. However , meds change frequently, and sometimes I'm testing twice a week. Alere, company marketing meter and strips, is sending what I need so far.

    If you contact Alere they will send you or your doctor 'Physician Order Form' to get process going. You can call Alere at 1-877-262-4669. I have had very good luck with them.

    You may want to consider going to Coumadin Clinic and lab several times for dual testing to determine accuracy of meter for you. You don't want to get a meter that does not work for you.

    Good luck.

    Nancy in WV

  • Hi Nancy--This is great news for me. I'm sure my md would approve this as long as I promise to go into the office once a month or less often for a quick check. Do you just call your doctor when you're numbers are too high or too low to change warfarin dosage?

    I know Medicare pays 80%. Do you have a secondary that pays the rest or does Medicare pay the whole thing? I'm so anxious since my INR sky rocketed for no apparent reason.

    Thank you again.

    Loretta

  • So far I have been texting results once a week to my doctor. Also, you will have app from Alere on your phone or computer and report your results to them. If I am way out of INR range, I retest in 3 days and text that result to him and Alere. Alere maintains a strict control over INR results--must be a liability thing. However, my doctor is leaving his current position to become a hospitalist making more money and working less. I'll probably set up something similar with my hematologist who agreed to monitor my INR.

    I do have a secondary insurance (Mutual of Omaha)--best secondary we could find in West Virginia. Since this meter is so new, unsure how much I will actually end up paying. Will let You know when I find out.

    Nancy in WV

  • Thank you so much for the information. I'd probably have to call the information in to my doctor if it's out of range. My original wonderful internist also left after taking such great care of me and INR and now my doctor is part of a practice and if she's not available or on vacation, I see her colleagues and unfortunately they often have different opinions on my warfarin amounts or differing opinions of what my INR means having APS. It's frustrating.

  • I hope it all works out for you. MaryF

  • Thank you Mary.

  • PS NYC doesn't have regular Coumadin clinics believe it or not but my internist does not the finger stick blood test which I've been getting.

  • Hi Loretta,

    I can not remember just now if you are Lupus Anticoagulant?

    If so, it can be a bit difficult with the INR if you are not allowed to selftest rather often and also do doubletests the first months at a hospital lab to find out if there is a big difference between the two values (fingerprick at the machine and vein-value at the lab). There can be a difference but it is vital that the difference is always the SAME. Otherwise it is difficult to trust your values from your machine when you do not take vein-values so often.

    Best wishes from Kerstin

  • I have APS but I believe I was told I couldn't be tested for Lupus Anticoagulant while I was on Warfarin.

    I'm hopeful that my doctor will agree with me to have me self test with periodic lab tests for accuracy. Right now she does the finger prick which is quick and easy. My rheumatologist does a lab test every 4 months when I see her. Where I am in New York City, self-testing is rarely if ever used. Although seriously I haven't met anyone aside from myself who has APS. I'm going to make an appointment with the Barbara Volker Women's Center in the Hospital for Special Surgery. I wanted to see Dr. Lockshin but he's retired. Dr. Erkan is there now and the only expert I know of. However, recently I was told he is no long recommended on Health Unlocked but where does one with APS go in New York City?

    It's good to hear from you Kerstin. Have a great day.

    Loretta

  • If you do the fingerpricktest it is important to also do a veintest the same day, I do it 2 hours later in the lab at the hospital.

    Nowadays I do it not very often but before I had to do doubletests every week to see if there was a difference in the readings. If you are Lupus Anticoagulant (which you do not know if you are as you are on Warfarin already) there is often a difference of perhaps 1.0 between the two tests so you see it is very important indeed to find out. I do not say there is a difference but you must find out if it is!

    For your own safety please find out! If I have 5.0 on my CoaguChek XS I have probably 4.0 in the vein at he hospital-lab.

    Kerstin

  • It is the vein-value that counts and is reliable!

    Kerstin

  • It's very frustrating because my doctor only does finger prick. I just called Alere (thanks to Nancy in WV on this site) and they are checking to see if my insurance pays for the CoaguChek. My INR has gone from 13.6 with hospitalization on 6/27 to normal range then it started climbing again. It was 1.3 this morning w finger prick so they are adjusting my meds again. My doctor thinks the company that gives me my meds may have changed manufacturers which may have affected my INR too.

    Thanks for your support Kerstin.

    Loretta

  • That's a risk for some of us, who are sensitive to all of the ingredients in the medicine, not just to the warfarin.

    So when the manufacturer of the generic switches up the binders and fillers, it can affect how your body takes up the warfarin. (All medicines contain fillers and binders.)

    "Jantoven" is a brand generic medicine. It contains warfarin, plus fillers and binders (like all medicines). The difference is that the fillers and binders in Jantoven never change, just like they never change with brand Coumadin. This may give you a more stable INR. It's a "generic" but without the risk of a typical generic. Jantoven is less expensive than Coumadin

    This may be something to inquire about.

  • Thank you. My doctor asked me to check to see if the mail order company I get my warfarin from changed manufacturers with my orders recently since my levels have been all over the place.

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