 | With Health Insurance: Copay or 10%-50% Coinsurance |
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 | Without Health Insurance: $1,000-$100,000+ |
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| Blood clots routinely form during healing, but can cause serious problems -- and even death -- when they form unnecessarily. Symptoms can include pain, swelling and tenderness at the location of the clot or numbness and shortness of breath. | | |
| Typical costs: | - For patients with health insurance, out-of-pocket costs for a blood clot typically include a copay or coinsurance of 10%-50%, prescription drug copays and follow-up doctor visit and laboratory test copays. Health insurance typically covers treatment of a blood clot.
- For patients not covered by health insurance, the cost of treatment depends on the type and location of the blood clot. It can vary from less than $1,000 for a superficial clot that requires warm compresses and anti-inflammatory medication to $10,000 or more for a clot deep in the body that requires hospitalization up to $100,000 or more for an arterial embolism that requires bypass surgery.
- For example, according to the U.S. Agency for Healthcare Research and Quality, the average cost of a hospital-acquired deep venous thrombosis is $10,000. Baptist Memorial Health Care in Tennessee charges about $11,000, not including doctor fee, for treatment of a DVT. Pali Momi Medical Center in Hawaii charges about $17,500 to repair a blockage in a vein, but will reduce the bill to $10,600 for uninsured patients who pay within 30 days or to $12,300 to those who pay in 60. If heart bypass surgery is required, it typically costs $70,000 -$200,000 or more.
What should be included: | - For venous clots -- in which blood clots in a vein -- treatment depends on the location of the clot. For a superficial venous clot, in which the clot is near the surface of the skin, treatment typically consists of warm compresses and non-steroidal anti-inflammatory drugs.
- For a deep venous clot -- deep venous thrombosis in which the clot is in the deeper veins of the body, usually the legs or pelvis, and can pass through the blood stream and travel to the lungs, heart or brain, more aggressive treatment is required. Typically, the blood-thinning medication heparin is administered intravenously to stop more blood clots from forming. Another blood-thinning medication, warfarin (brand name Coumadin), typically is given orally. In some cases, a drug such as urokinase might be given by injection to break up existing clots.
- For arterial embolism -- either a blood clot or piece of plaque that blocks the artery and can cause tissue death, heart attack or stroke -- treatment might include anticoagulant drugs, IV pain medication, clot-dissolving drugs and, in some cases, a procedure such as angioplasty or bypass surgery.
- The American Society of Hematology offers an overview of blood clots.
Additional costs: | - After initial treatment, the patient might be put on an anti-coagulant drug such as warfarin (Coumadin). For a one-month supply, Drugstore.com charges about $15 -$25 for the generic and $50 -$70 for the brand name drug.
- Another drug such as Lovenox or Arixtra -- both injectable anti-coagulant drugs -- might be prescribed temporarily, along with warfarin. Drugstore.com charges more than $700 for a one-month supply of Lovenox and $1,600 or more for a one-month supply of Arixtra. Insurance often covers these drugs when medically necessary, such as for patients who cannot take warfarin.
- Patients on anti-coagulant drugs require regular monitoring. For warfarin, a PT (prothrombin time)/INR (international normalized ratio) test -- as frequently as once per week, to make sure the drug is working effectively. This typically costs $6 -$25 per test at a doctor's office or laboratory.
Discounts: | - Many hospitals give discounts of 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System in California offers a 35% discount.
- The manufacturer of the anticoagulant drug Coumadin, Bristol-Myers Squibb, participates in the Together Rx Access program, which offers discounts of 25%- 40% on certain drugs. The manufacturer of Lovenox, Sanofi-Aventis, offers the drug for free to uninsured patients who qualify, through its patient reimbursement program.
Shopping for blood clot treatment: | - The U.S. Department of Health and Human Services offers a hospital comparison tool that lists hospitals near a chosen zip code, how far away they are and whether they offer emergency services.
- A patient might need to see a hematologist or other specialist. The American Society of Hematology offers a hematologist locator.
- It is important to make sure any specialist board-certified.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Article updated February 2012 |
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