Monoclonal Antibody Treatment
Medstar can provide monoclonal antibody (MAB) Bamlanivimab & Estesevimab and REGEN to high-risk COVID-19 patients.
A physician must complete this cover sheet and referral form and fax it with a face sheet that includes the patient's phone number to 586-371-5080. Patients covered by a Medicare Advantage plan must also include their Medicare number found on their Medicare card.
Upon receiving the completed referral and paperwork, Medstar will schedule the appointment with the patient.
Please note: our average turnaround time right now is three days after Medstar receives the completed paperwork and verifies the patient's information and eligibility; however, it may be longer based on demand.
The MAB treatment takes 15-30 minutes, and the Medstar clinician monitors the patient for an hour afterward. After the visit, Medstar will send the referring physician the completed form and chart from the appointment upon request.
- REQUIRED FORMS
- Fax Number: 586-371-5080
It is the patient’s responsibility to check with their healthcare insurance provider about MAB coverage, co-pays, and deductibles. We recommend patients ask their healthcare insurance provider about coverage before their physician submits a referral.
Medstar is authorized to provide MAB to patients who reside in the following counties:
The patient must be:
- Age (≥ 12 y.o.)
- Weight (≥ 40 kg)
- Mild to moderate COVID-19; high-risk for progressing to severe COVID-19 and/or hospitalization (see below), positive test (antigen or PCR), within 10 days of symptom onset
The patient meets at least one of the following high-risk criteria:
- Is ≥ 65 years of age
- Has a body mass index (BMI) ≥ 25
- Has chronic kidney disease
- Has diabetes
- Has immunosuppressive disease
- Is currently receiving immunosuppressive treatment
- Cardiovascular disease or hypertension
- Chronic lung diseases
- Neurodevelopmental disorders or other conditions that confer medical complexity
- Sickle cell disease
- Having a medical-related technological dependence not related to COVID-19 (e.g., tracheostomy, gastrostomy)
- Is 12-17 years of age and has: BMI > 85th percentile for their age and gender-based on CDC growth charts; sickle cell disease; congenital or acquired heart disease; neurodevelopmental disorders; medical-related technological dependence; OR asthma, reactive airway or other chronic respiratory disease that requires daily medication for control.
- Other medical conditions or factors that place the patient at high risk for progressing to severe COVID-19
Monoclonal Antibodies are NOT AUTHORIZED for use in patients who are hospitalized due to COVID-19, OR who require oxygen therapy due to COVID-19, OR who require an increase in baseline oxygen flowrate due to COVID- 19 for those on chronic oxygen therapy due to an underlying non-COVID-19 condition.
Monoclonal Antibody Therapy is NOT AUTHORIZED for pre-exposure prophylaxis.
Additional MAB Information
Providers or patients in need of assistance locating an infusion site or connecting with a clinical trial can call the national Monoclonal Antibody Therapy Call Center.
You can also visit https://covid.infusioncenter.org to find additional MAB treatment sites.