Beyfortus (RSV Preventative Antibody)

Infants born between April 2024 through current may qualify for the antibody. Those less than 2 years old with a history of prematurity, or other chronic conditions may also qualify. 

1) Please contact your insurance company – the number on your ID card is the number you should call. ****You must get a reference number for your call.

2) Beyfortus is not considered a vaccine, it is a “preventative antibody” and therefore is not treated like every other vaccine. 

3) Let the representative know that you would like to find out if Beyfortus is a covered benefit under your plan. If they ask you for a CPT code, it will either be 90380 if your infant is less than 5kg (approx. 11.5lbs) or 90381 if above 5kg

4) If this is a covered benefit, please then take the opportunity to ask them if you have met your deductible or not, and/or what you would expect to pay for a co-pay. Some of you may owe nothing, others may be responsible for the entire cost of $625

5) Once you have spoken to your insurance company and received a reference number, please portal message us with the reference number and expected co-deductible/co-pay. Please expect to pay this amount when you come for your appointment. 

6) Once we have received your message, we will then confirm eligibility. This may take up to 48 business hours and then your infant will be scheduled.