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Understanding the Cost of Infusion Therapy

At Sands Health, we know that the cost of infusion therapy can feel overwhelming. Our team is here to partner with you every step of the way—helping you navigate insurance, explore financial assistance options, and minimize your out-of-pocket costs whenever possible.

What Determines the Cost of Infusion Therapy?

Several factors influence the cost of your treatment, including:

  • Medication Type & Dosage – The cost of infusion therapy varies based on the specific medication prescribed and the required dosage. Some medications are more expensive than others, especially brand-name specialty drugs.
  • Insurance Plan – Your health insurance plan significantly influences your out-of-pocket expenses. Factors such as deductibles, co-pays, and co-insurance vary between plans and determine the portion of costs you are responsible for.  Additionally, every insurance company has its own formulary, or list of covered medications, which can affect how much you pay. The same medication may be covered differently from one plan to another. If a medication isn’t covered or has a high out-of-pocket cost, we’ll work with you and your prescriber to explore alternatives.
  • Frequency & Duration of Treatment – The number of infusions and length of your treatment plan can impact total costs. We’ll help you understand what to expect and plan accordingly.
  • Site of Care – Infusions given in a hospital setting often have higher costs than those administered in an ambulatory infusion center or at home. By receiving treatment in the most cost-effective setting, you can often reduce your overall expenses.

Navigating Insurance & Financial Assistance

Insurance can be complicated, but you don’t have to figure it out alone. Sands Health partners with patients to help maximize coverage and minimize costs.

  • Insurance Verification – We will review your insurance benefits, explain your coverage, and provide an estimate of your financial responsibility before treatment begins.
  • Prior Authorization – Many infusions require approval from your insurance company before treatment. We handle this process on your behalf, so there are no delays in getting the care you need.
  • Appeals – If an insurance company denies coverage, we don’t stop at the initial denial phase. We assist in coordinating peer-to-peer reviews between your physician and the insurance provider, ensuring your doctor has the opportunity to advocate for your treatment. If an appeal is necessary, we help facilitate the process. Our goal is to exhaust every available option to secure approval for your prescribed therapy.
  • Patient Assistance Programs – Many pharmaceutical manufacturers offer co-pay assistance or financial aid programs to help lower the cost of medications. Our team will identify available resources and assist with enrollment.
  • Exploring Alternatives - If your medication isn’t covered or has a high co-pay, in addition to appeals and patient assistance programs, we’ll also work with your prescriber to explore alternative options that may help.

Our Commitment to You

We believe cost should never be a barrier to receiving the treatment you need. Sands Health is committed to transparency, compassion, and advocacy—working with you to find solutions that make your infusion therapy as affordable as possible.

 

For more information on insurances we accept and patient assistance programs, visit our Insurance and Patient Assistance pages.

Let us handle the complexities of cost and coverage—so you can focus on your health.