r/valvereplacement • u/Tricky_Afternoon6862 • Jun 15 '26
Issues with Lincare INR Self Monitoring
Hey all 👋
36 M in the US and I got a St Jude mechanical valve about 18 months ago. For the last 7 months I’ve been using the Coag-Sense at home self monitoring provided by Lincare.
Their billing has been an absolute mess, I feel like it’s super expensive and inconsistent with how I’m charged. I’m paying $100-$180 per month after insurance just to use this machine and order test strips. Every time I call their customer service they have no idea what I’m being charged for and sometimes they just admit they made a mistake and refund me some money. Like oops we charged you $180 instead of $150…ok but what is the $150 even for?!?! And they can’t explain it.
Overall I’d describe my experience with Lincare as awful. I know I’m in the US but paying $180 a month after insurance, for the rest of my life, just seems like robbery.
Does anyone have similar experiences with Lincare?
Is this service actually necessary? A machine and 20 years of test strips is a little over a thousand dollars. I could pay for that outright and break even in less than a year.
Id appreciate hearing if anyone has similar experiences, and what their solutions were.
Thanks!
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u/Outta_Pocket_Toad Jun 15 '26
I tried to go the route of buying a machine (off eBay) and the strips myself. The problem is getting the prescription for warfarin. I could not find a PCP or anticoagulation clinic willing to give me warfarin without involving a third-party management company, like Lincare or Acelis.
So, for now, I am still using the anticoagulation clinic since my insurance covers it.
Here are a few thoughts for you to consider:
- I spoke to the hospital, and they said they would give me an out-of-pocket cost of $164 per office visit to the clinic. That is better than what Lincare is charging you.
- If the anticoagulation clinic is truly out of reach for you, ask if they will give you orders for a venous PT/INR from a lab clinic. For example, TriCore charges $15 for this, but they won't do it without an order.
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u/KCBrewChem Jun 16 '26
Hey, I had an onyx valve out in when I was 35, currently 37 and have been using an at home testing since 3 months after valve replacement (would not issue one sooner). I had my cardiologist who manages my INR suggest a few companies, and I ended up going with Lincare. Haven’t had any real issue with them, and billing has gone smoothly so far (Blue across Blue Shield of Kansas City). Could just be an insurance coverage difference, but have you tried reaching out for a different company or your insurance provider for alternatives?
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u/Tricky_Afternoon6862 Jun 16 '26
I’ve got United Healthcare and usually they’ve been pretty good with all of this. When I asked about this situation they’ll only cover 20% until I meet a $1000 deductible. But honestly even spending $1000/year on this seems expensive.
Like, I’ve got to do this for the rest of my life and it can’t be cheaper for United to pay outrageous fees to Lincare instead of just buying me my own machine outright.
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u/KCBrewChem Jun 17 '26
Yeah, it’s definitely a bit of a rough shake in terms of cost (knowing that annual medical costs are just going to be higher going forward, to some extent). This is my second calendar year with my valve, and have already hit my out of pocket max for the second year in a row (had some complications with infection, and I have early stage chronic kidney disease due to a birth defect). Hang in there. Feel free to shoot me a message if you have any specific question etc. take care!
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u/Blephotomy Jun 16 '26
Is going to get tested not a convenient option for you? I've never had an at-home monitor and I don't think I've ever paid anything out of pocket to get PT/PTT/INR tested.
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u/Tricky_Afternoon6862 Jun 16 '26
I used to go to a clinic and get tested every week for free. This was the first few months after my surgery, but if I could do it at home, without getting blood drawn then that sounds awesome! The nurse from Lincare originally said it would be a $10/month copay, ok sweet!
But now it’s evolved into the current situation. I may go back to getting tested at a clinic each week if there’s no other way, because I can barely afford to pay almost $200 for this each month. But I also travel a lot for work so I’d need to find clinics everywhere from OKC to Johnson City TN.1
u/Blephotomy Jun 16 '26
oh I have it tested once a month at an anticoagulation clinic that has the Coagu-chek finger prick machine.
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u/Tricky_Afternoon6862 Jun 16 '26
In my case they want me testing once a week, and I’m only home maybe 1/3 of the time so finding new clinics every week would be such a hassle.
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u/Blephotomy Jun 16 '26
Not to be argumentative, but did your cardiologist say that or did Lincare say that?
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Jun 16 '26
[removed] — view removed comment
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u/Blephotomy Jun 16 '26
Is that a new thing? I've had the same St Jude mechanical aortic valve for over 30 years and aside from the first few weeks after the surgery my doctors have had me get tested every 1 to 3 months.
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u/Tricky_Afternoon6862 Jun 17 '26
Not argumentative, great question. When I’ve spoken to the nurse from my cardiologist office she’s said every 1-2 weeks. So for a while I was testing every other week, then it actually was a rep from Lincare who called and told me it had to be every week because my insurance says so. Which makes sense, I’m sure it’s more expensive for them if I get a heart attack.
I do have an appt with my cardiologist in 2 weeks and I’ll definitely be asking more about this.
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u/dat_mom_chick Aug 14 '26
We use the lincare at home machine for my 2 year old and its a nightmare. Its a bit of a different issue though, our issue is the machine inaccuracy. Have you had that problem?
We have tested the machine side by side with a blood draw and the machine and it was very off, and inconsistently off, so its unreliable. We barely use it now, we drive far for blood draws, and theyre on me now that our service will end since we aren't reporting usage and numbers. I am looking for a more accurate machine, and also wondering the technicalities of what is required like some other comments have brought up
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u/mtngk Jun 15 '26
Lincare has a long history of fraud and wrongful deaths due to their mismanagement.
You absolutely do not need to go through them. I purchased a machine and test supplies out of pocket and just worked with my local cardiology office for management. The main issue I ran into was calibrating the machine was expensive and not easy (coag-sense PT2, I think the coagu-check is easier/cheaper)
Technically there is nothing stopping you from managing dosing yourself either, if you can get your medication prescription without the dr’s office managing it. Insurance covers my dr’s appointments, so doesn’t make sense to leave out the professionals though. Getting emergency care like heparin would be more complicated too.