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Synagis vaccine

boymom10boymom10 member
in Special Needs
Hi all - I'm hoping this is the right place to ask. My son was born in January with a heart defect. It was repaired at two-months-old in March, and he was discharged from the hospital after RSV season ended earlier this year. We are now talking to our pediatrician about the Synagis vaccine. He has been approved to receive it, but we just found out how crazy expensive these shots are. Insurance will only pay once we've met our deductible completely, which is rather high. Anyone know of any kind of assistance program? Or, tips on how to get insurance to cover more? I feel like we've had to battle insurance on everything.
Mommy to two sweet boys
A 9.22.10
E 1.16.13

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Re: Synagis vaccine

  • Happy2bNappyHappy2bNappy member
    I thought it was just preemies or babies with lung issues who gets synagis. I know it is very expensive. Do you qualify for medicaid? DS had medicaid (32 week preemie) and to what I understand as long as the child meets the criteria medicaid covers the shots without issues.
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  • boymom10boymom10 member
    Infants with certain heart conditions qualify for synagis as well. We don't qualify for Medicaid. At least, I don't think we do. I know our income exceeds their requirements, but is there another way to get qualified? Anyway, since we don't have it, that's why I'm trying to research other options. It just seems like there should be another way to get it covered at least a little bit more. 
    Mommy to two sweet boys
    A 9.22.10
    E 1.16.13

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  • boymom10boymom10 member
    Sahara78 said:
    DD qualified for a $2K gift card credit toward our out of pocket Synagis charges early this year. The specialty pharmacy that shipped the injections to our pedi signed us up. There is a link with info in the Preemie RSV thread. https://forums.thebump.com/discussion/8511867/rsv-information-please-read
    Thank you!!
    Mommy to two sweet boys
    A 9.22.10
    E 1.16.13

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  • Zeidy01Zeidy01 member
    You could ask at the preemie board. Our insurance covered it but the only issue was the increase of cost with the increase of weigh gain. It can get super expensive.
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  • realisticdreamsrealisticdreams member
    i'm not sure what state you are in but the other type of medicaid for when you are over income is called waiver medicaid, some states call it the katie beckett waiver, others have their own name.  I would look into that, it goes by the childs diagnosis/medical condition & their income only, not the parents, good luck!
    DD1(4):VSD & PFO (Closed!), Prenatal stroke, Mild CP, Delayed pyloric opening/reflux, Brachycephaly & Plagiocephaly, Sacral lipoma, Tethered spinal cord, Compound heterozygous MTHFR, Neurogenic bladder, Urinary retention & dyssynergia, incomplete emptying, enlarged Bladder with Poor Muscle Tone, EDS-Type 3. Mito-Disorder has been mentioned

    DD2(2.5): Late term premie due to PTL, low fluid & IUGR, Reflux, delayed visual maturation, compound heteroygous MTHFR, PFAPA, Bilateral kidney reflux, Transient hypogammaglobulinemia, EDS-Type 3


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  • boymom10boymom10 member
    Thank you all so much! This is a huge help.
    Mommy to two sweet boys
    A 9.22.10
    E 1.16.13

    Report Reply
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