How to Get IVIG Therapy Covered in Oregon: A Step-by-Step Guide for Patients
For many patients with immune deficiencies or autoimmune conditions, IVIG therapy (intravenous immune globulin) can be life-changing—but navigating insurance coverage can feel overwhelming.
At Vital Care of Portland, we help you understand your options, complete authorizations, and minimize out-of-pocket costs so you can focus on your health.
Below is a simple, step-by-step guide to getting IVIG therapy approved and covered in Oregon.
Step 1: Confirm Your Diagnosis and Medical Necessity
Insurance plans require documentation showing that IVIG is medically necessary.
Your provider will typically need to submit:
A confirmed diagnosis (such as CVID, CIDP, Myasthenia Gravis)
Relevant lab results and clinical notes
A history of previous treatments or failed therapies
Our team at Vital Care coordinates directly with your prescriber’s office to ensure all clinical details are submitted correctly the first time.
Step 2: Verify Your Insurance Coverage
Different insurers in Oregon (like UnitedHealthcare, Aetna, Cigna, Human, Regence, Moda, Providence, and PacificSource) may process IVIG under medical (Part B) or pharmacy (Part D) benefits. We’ll help you determine which benefit applies and verify your coverage before therapy begins.
Our financial coordination team reviews:
Benefit limits and copay structures
In-network infusion options (home vs. suite)
Any preauthorization or step-therapy requirements
Step 3: Prior Authorization and Supporting Documentation
Most insurers require a prior authorization (PA) before IVIG therapy starts.
We help your provider gather everything needed for approval, including:
Diagnosis and ICD-10 codes
Treatment plan and dose information
Historical notes on disease progression
We track your authorization status and keep you informed along the way so there are no delays or surprises.
Step 4: Explore Financial Assistance Programs
If your out-of-pocket costs are high, you may qualify for manufacturer copay programs, foundation grants, or patient assistance support. We proactively screen for these programs and help you apply. Our goal is to ensure that cost never stands in the way of your treatment.
Step 5: Begin Infusion Therapy—at Home or in Our Suite
Once authorization is approved, our clinical team coordinates your first infusion.
We’ll discuss whether you prefer home infusion or treatment in our private infusion suite in Clackamas, Oregon.
Both options are supervised by our licensed pharmacists and infusion nurses to ensure a safe, comfortable experience.
How Vital Care of Portland Can Help
We handle insurance verification and prior authorizations
We coordinate directly with your prescriber
We identify financial assistance and payment plan options
We provide therapy in-home or in our infusion suite
If you’re struggling to get IVIG therapy started or approved, contact us. We’ll help guide you through every step of the process.
