Information for Beneficiaries - IVIG
IVIG Enrollment Applications Only Accepted until 12/15/2023
The IVIG demonstration will be ending on December 31, 2023. However, Medicare will continue to cover intravenous immune globulin supplies and nursing services in the home for beneficiaries with a diagnosed primary immune deficiency disease, as these items and services will be covered under a permanent Medicare benefit effective January 1, 2024.
Due to the IVIG demonstration ending, the last date that enrollment applications will be accepted for the demonstration will be December 15, 2023. Applications must be postmarked or faxed by midnight on December 15, to be considered for enrollment in the IVIG demonstration. We will send a denial letter for enrollment in the demonstration for applications received after this date.
Information for Beneficiaries
Applications for participation in the IVIG Demonstration will continue to be accepted on a rolling basis until Medicare reaches or projects it will reach the statutory limit on funding and/or enrollment (6,500 beneficiaries). At this time, applications are still being received.
Please note that in order to be enrolled in the IVIG Demonstration, a beneficiary must:
- Be covered under Medicare Fee-For-Service and enrolled in Part B,
- Have a diagnosis of Primary Immune Deficiency Disease (PIDD), and
- Receive treatment by intravenous infusion, and
- Not be currently covered under a home health episode of care.
IVIG Demonstration Enrollment Application
All beneficiaries must complete and submit a signed application in order to be considered for this demonstration. The blank application may be printed and completed manually or filled in online and printed before signing. Once completed and signed by the beneficiary, the application must also be signed by the beneficiary's treating physician:
Your version of Adobe Acrobat may offer a feature to "digitally sign" the application document. Users should not use this feature as it does not properly qualify as a signature. Once completed, the application must be printed and signed with an ink pen.
IVIG Demonstration Enrollment Application Guide
These guides provide complete instructions for completing the IVIG Demonstration Enrollment Application.
Submitting the Application
By Fax - Completed IVIG Demonstration applications can be faxed to: 701-277-2428.
By Mail - Completed IVIG Demonstration applications can be mailed to:
Noridian Healthcare Solutions
IVIG Demo
PO Box 6788
Fargo ND 58108-6788
Overnight Mailing
Noridian Healthcare Solutions
IVIG Demo
4510 13th Ave S Suite 1
Fargo ND 58103-6646
Notification Process
All IVIG Demonstration applicants will be notified within twelve business days of receipt of a complete application of their status and the effective date of their coverage under the demonstration.
Effective Dates for Enrollment
Completed applications received by the 15th of the month, if eligible, will have coverage effective the first of the next month.
Completed applications received after the 15th of the month, if eligible, will have coverage effective the fifteenth of the next month. For example, if an application is received on September 15, coverage will be effective October 1. If an application is received on September 20, coverage will be effective October 15.