Beyfortus

Beyfortus for infants under 11 pounds, now available through insurance!

Primary Care and Community Patients Welcome

Beyfortus (Nirsevimab) is a monoclonal antibody against the Respiratory Syncytial Virus (RSV). Beyfortus reduces hospitalizations and death in babies < 8 months old with RSV by up to 80%. It is recommended by the FDA, CDC, and the Pediatricians at Potomac Pediatrics.

Eligible patients may still qualify for Synagis, which is also covered by insurance and may have a different insurance coverage benefits. Your Pediatrician will discuss this with you if your child meets criteria.

Parents of eligible patients may self schedule via the Potomac Pediatrics website. Patients will have an appointment with a provider during which they will be weighed to determine eligibility for the dose. If eligible, Beyfortus will be given at that time.

Eligibility Criteria:

• Child must be less than 11 pounds at the time of their appointment. No exceptions will be made for a child weighing more than 11pounds.
• Child cannot have a known bleeding disorder.
• Mother did not receive maternal RSV vaccine while pregnant.

INSURANCE COVERAGE NOTICE

Please be advised that this is now an insurance eligible therapeutic injection (not a vaccine). It is NOT covered under preventative care benefits and therefore your insurance will not cover this injection at 100%. Your deductible, copay, or coinsurance will apply. If you have not met your deductible for the year or have a cost sharing plan, you will be responsible for the cost of the visit and the Beyfortus injection.

We will verify your benefits and deductible status prior to your appointment. If your deductible has not been met, upon check-in, a front desk team member will collect $600 as a deposit for the cost of your consultation and injection. If you have coinsurance responsibility a $100 deposit will be collected at check-in. Please note, an additional balance may be due once your claim processes.

In the event your child weighs over 11 pounds and cannot receive Beyfortus, and you paid a deductible deposit, you will be refunded $500 at the end of your appointment. The consultation will be billed to your insurance; in accordance with our financial policy your $100 deductible deposit will remain on file.

Call (301) 279-6750 to schedule your Beyfortus injection.