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> Medicare Part B and Insulin for Pumpers
Arlene S.
post Dec 26 2011, 04:42 AM
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Starting January 1 Medicare will be my primary insurance (now it's my secondary) and I will be getting insulin through Part B because that's how it works if one is on a pump. Does anyone get insulin through Part B and if so how does it work? Do you get it through a pharmacy or do you use mail order? Is there a copayment? I called Medicare and was referred to a list of suppliers but the list is just for durable medical equipment suppliers within a certain area and it doesn't list insulin.





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Arlene S.
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MM CGMS 2006-2014
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Evona
post Jan 1 2012, 02:03 PM
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Arlene -

I can only speak of my own experience with Medicare and part B for insulin. It took me almost a year to find a mail order pharmacy that was willing to bill under part B and NOT part D for the insulin for my pump. The local pharmacies in my town either did not know how or they were unwilling to bill under part B.

The mail order place I use is PrescriptionSolutions. If you call them ask to speak with the Diabetic department as the regular representatives seem like space cadets at times.

Medicare does have some strange rules, or my secondary insurance does. I am required to see my Doctor every 3 months plus I am also required to submit a 30 day log of my blood sugar readings every six months. Medicare uses this to determine how many test strips I am 'eligible' to have.

If there is anything else I can help you with, I will certainly try. It is a huge relief to have Medicare pay for the insulin that I use in my pump. Up until July 2011 I was paying out of pocket for it. Best wishes to you.


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Evona
post Jan 1 2012, 08:28 PM
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Check the Medicare.gov website, but I don't have a co-pay for my insulin as long as it is used in a pump.

Also, you might want to make the log book records you send a 31 day record. One time they were going to deny my coverage for test strips because I had only sent a 30 day record. They claimed my records were "in-complete".


--------------------
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Arlene S.
post Jan 1 2012, 11:23 PM
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QUOTE(Evona @ Jan 1 2012, 09:03 AM) *
Arlene -

I can only speak of my own experience with Medicare and part B for insulin. It took me almost a year to find a mail order pharmacy that was willing to bill under part B and NOT part D for the insulin for my pump. The local pharmacies in my town either did not know how or they were unwilling to bill under part B.

The mail order place I use is PrescriptionSolutions. If you call them ask to speak with the Diabetic department as the regular representatives seem like space cadets at times.

Medicare does have some strange rules, or my secondary insurance does. I am required to see my Doctor every 3 months plus I am also required to submit a 30 day log of my blood sugar readings every six months. Medicare uses this to determine how many test strips I am 'eligible' to have.

If there is anything else I can help you with, I will certainly try. It is a huge relief to have Medicare pay for the insulin that I use in my pump. Up until July 2011 I was paying out of pocket for it. Best wishes to you.


Evona,

Thanks. My very savvy endo did not know that insulin is covered for pumpers by Part B. I spoke to my pharmacist who said he was not licensed to bill Medicare Part B for insulin but he would get it from a pharmacy that does have a license. He applied for one but hasn't received it yet.

I called Prescription Solutions DME department regarding strips and was told that Medicare does require a log every so often. I never inquired about insulin because I prefer getting it from a pharmacy. Is your secondary insurance a Medigap or a supplement. We have the AARP Medicare Supplement as our secondary.

Thanks. This is all new to me after having private insurance as our primary for so many years with Medicare as secondary.



QUOTE(GA Hiker @ Jan 1 2012, 01:27 PM) *
Arlene,

How much is he insulin copay with Medicare? As of today, my copay for insulin is increasing 250%!

Thanks, Barbara


Barbara,

With Medicare as your Primary you should be able to get your insulin through Part B since you are on a pump. I believe the copay is 20% which your secondary should pick up. You just need to find a supplier who will bill Part B for insulin.


--------------------
Arlene S.
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MM CGMS 2006-2014
Dexcom G4, June 2014
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Arlene S.
post Jan 1 2012, 11:52 PM
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QUOTE(Evona @ Jan 1 2012, 09:03 AM) *
Arlene -

I can only speak of my own experience with Medicare and part B for insulin. It took me almost a year to find a mail order pharmacy that was willing to bill under part B and NOT part D for the insulin for my pump. The local pharmacies in my town either did not know how or they were unwilling to bill under part B.

The mail order place I use is PrescriptionSolutions. If you call them ask to speak with the Diabetic department as the regular representatives seem like space cadets at times.

Medicare does have some strange rules, or my secondary insurance does. I am required to see my Doctor every 3 months plus I am also required to submit a 30 day log of my blood sugar readings every six months. Medicare uses this to determine how many test strips I am 'eligible' to have.

If there is anything else I can help you with, I will certainly try. It is a huge relief to have Medicare pay for the insulin that I use in my pump. Up until July 2011 I was paying out of pocket for it. Best wishes to you.


Evona,

I have been able to get to my account online at Prescription Solutions but they do not list One Touch strips. What kind of strips do you get from them?




--------------------
Arlene S.
Type 1
Pumped with Minimed 1993-2014
MM CGMS 2006-2014
Dexcom G4, June 2014
t:slim, June 2014
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Manxman
post Jan 2 2012, 02:18 AM
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Re: Medicare payment for BG Monitor test strips-- watch out! If you have secondary insurance that will pay for test strips, use that and don't bother trying to use Medicare. With Medicare, your log MUST show results for every test and show total tests to justify the quantity that you try to order. If you log falls just ONE test short of the quantity that you want, Medicare will deny your purchase and only pay for the next lower quantity of strips.

Whenever I feel hypo, I don't bother to test to see how low I dropped, I just treat the hypo condition and test the next time that my pump alerts me to do so. But under those conditions, my regimen of six test per day fell a couple of strips short of the 540 (550) strips that I tried to order. Medicare would only pay for 500 strips. So I stopped trying to order with Medicare as the insurance payment, and reverted to my secondary insurance for all orders.

HealthCare CA pays for the strip orders with a $40.00 copay for a 30-day supply. There is no copay with Medicare orders, but I don't mind the secondary insurance copay that is necessary to get the quantities that I actually need without argument. $40.00 per 30-day supply is better than having to pay out-of-pocket over the counter retail for the extra strips that I may need over whatever Medicare decides to fund for me.

This post has been edited by Manxman: Jan 2 2012, 02:22 AM
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GA Hiker
post Jan 2 2012, 03:05 AM
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QUOTE(Arlene S. @ Jan 1 2012, 06:23 PM) *
With Medicare as your Primary you should be able to get your insulin through Part B since you are on a pump. I believe the copay is 20% which your secondary should pick up. You just need to find a supplier who will bill Part B for insulin.

Shortly after I went on the pump, knowing that "Medicare pays for insulin if you are on a pump," I asked my pharmacist what the copay would be using Medicare. She just said that it would be much higher than my regular rx insurance, which at that time and until today was $20 for a 3-month supply. But now I'm thinking that she may well have been using the Medicare Part D numbers, not Part B. I'm going to check again with the new pharmacist at my drug store and be specific about Part B. I'll also check with Prescription Solutions. I really don't like the idea of getting my insulin mail order but depending on the numbers, I may try it.
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Manxman
post Jan 2 2012, 05:00 AM
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QUOTE(Manxman @ Jan 1 2012, 06:18 PM) *
Re: Medicare payment for BG Monitor test strips-- watch out! If you have secondary insurance that will pay for test strips, use that and don't bother trying to use Medicare. With Medicare, your log MUST show results for every test and show total tests to justify the quantity that you try to order. If you log falls just ONE test short of the quantity that you want, Medicare will deny your purchase and only pay for the next lower quantity of strips.

Whenever I feel hypo, I don't bother to test to see how low I dropped, I just treat the hypo condition and test the next time that my pump alerts me to do so. But under those conditions, my regimen of six test per day fell a couple of strips short of the 540 (550) strips that I tried to order. Medicare would only pay for 500 strips. So I stopped trying to order with Medicare as the insurance payment, and reverted to my secondary insurance for all orders.

HealthCare CA pays for the strip orders with a $40.00 copay for a 30-day supply. There is no copay with Medicare orders, but I don't mind the secondary insurance copay that is necessary to get the quantities that I actually need without argument. $40.00 per 30-day supply is better than having to pay out-of-pocket over the counter retail for the extra strips that I may need over whatever Medicare decides to fund for me.


Woops- typo. I meant to say HealthNet CA.
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Arlene S.
post Jan 2 2012, 05:05 AM
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QUOTE(GA Hiker @ Jan 1 2012, 10:05 PM) *
Shortly after I went on the pump, knowing that "Medicare pays for insulin if you are on a pump," I asked my pharmacist what the copay would be using Medicare. She just said that it would be much higher than my regular rx insurance, which at that time and until today was $20 for a 3-month supply. But now I'm thinking that she may well have been using the Medicare Part D numbers, not Part B. I'm going to check again with the new pharmacist at my drug store and be specific about Part B. I'll also check with Prescription Solutions. I really don't like the idea of getting my insulin mail order but depending on the numbers, I may try it.


I was surprised that my endo didn't know that Medicare Part B pays for insulin for pumpers. He does have Medicare patients and I'm pretty sure some of them are on the pump. When you speak to your pharmacist you can show her page 10 of the following publication. The thing is that she may not be licensed to bill Part B. My pharmacist told me that it's very expensive to get the license. I think CVS is licensed but I'm not sure. I would prefer not using mail order for insulin but I will if I have to.

Medicare Publication


--------------------
Arlene S.
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MM CGMS 2006-2014
Dexcom G4, June 2014
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Evona
post Jan 2 2012, 01:54 PM
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QUOTE(Arlene S. @ Jan 1 2012, 05:52 PM) *
Evona,

I have been able to get to my account online at Prescription Solutions but they do not list One Touch strips. What kind of strips do you get from them?


I am sorry if I gave a wrong impression. I don't get my test strips from Prescription Solutions - I only get my insulin from them as I already was getting my pump supplies and test strips from Medtronics.

QUOTE(GA Hiker @ Jan 1 2012, 09:05 PM) *
Shortly after I went on the pump, knowing that "Medicare pays for insulin if you are on a pump," I asked my pharmacist what the copay would be using Medicare. She just said that it would be much higher than my regular rx insurance, which at that time and until today was $20 for a 3-month supply. But now I'm thinking that she may well have been using the Medicare Part D numbers, not Part B. I'm going to check again with the new pharmacist at my drug store and be specific about Part B. I'll also check with Prescription Solutions. I really don't like the idea of getting my insulin mail order but depending on the numbers, I may try it.


To be honest, I don't like the idea of getting my insulin mail order either, however for getting it without a copay, I felt like I could take a chance. My first shipment was June 2011 and my second was Sep 2011 (which are both hot weather months where I live). The insulin arrived in good condition in a small styrofoam box with two ice packs to keep the insulin at proper temperature.


--------------------
Type 1 Dx 4-21-2003
Medtronic 723, 8-21-2010
Dexcom CGMS. 9-2007 - self funded
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Arlene S.
post Jan 2 2012, 02:35 PM
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QUOTE(Evona @ Jan 2 2012, 08:54 AM) *
I am sorry if I gave a wrong impression. I don't get my test strips from Prescription Solutions - I only get my insulin from them as I already was getting my pump supplies and test strips from Medtronics.
To be honest, I don't like the idea of getting my insulin mail order either, however for getting it without a copay, I felt like I could take a chance. My first shipment was June 2011 and my second was Sep 2011 (which are both hot weather months where I live). The insulin arrived in good condition in a small styrofoam box with two ice packs to keep the insulin at proper temperature.


I'm sorry. I just assumed you got your strips from them. I'm going to call Prescription Solutions and if they don't send One-Touch I can get them from CCS. They have my records including my C-Peptide results. Or I will get them from Medtronic if they send a 3-month supply.





--------------------
Arlene S.
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MM CGMS 2006-2014
Dexcom G4, June 2014
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GA Hiker
post Jan 2 2012, 03:27 PM
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QUOTE(Arlene S. @ Jan 2 2012, 12:05 AM) *
I was surprised that my endo didn't know that Medicare Part B pays for insulin for pumpers. He does have Medicare patients and I'm pretty sure some of them are on the pump. When you speak to your pharmacist you can show her page 10 of the following publication. The thing is that she may not be licensed to bill Part B. My pharmacist told me that it's very expensive to get the license. I think CVS is licensed but I'm not sure. I would prefer not using mail order for insulin but I will if I have to.

Medicare Publication

I just called my pharmacy, RiteAid, and a local CVS. Both say they can do Part B but need all the paperwork before they can tell me the cost. Can you tell me what the "Medicare approved amount" is? I know that Medicare will pay for 80% and I will be left with the 20%. My secondary insurance probably will not pick that up, as they no longer pick up the 20% for test strips that Medicare covers. They want me to go through their pharmacy plan, CVSCaremark starting yesterday, that does not coordinate with Medicare. So I am trying to get the info to determine whether my pharmacy plan copay or Medicare 20% is the better deal. Hmmm, if I call Medicare, will they tell me their approved amount? Somehow I don't think so.
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Arlene S.
post Jan 2 2012, 04:58 PM
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QUOTE(GA Hiker @ Jan 2 2012, 10:27 AM) *
I just called my pharmacy, RiteAid, and a local CVS. Both say they can do Part B but need all the paperwork before they can tell me the cost. Can you tell me what the "Medicare approved amount" is? I know that Medicare will pay for 80% and I will be left with the 20%. My secondary insurance probably will not pick that up, as they no longer pick up the 20% for test strips that Medicare covers. They want me to go through their pharmacy plan, CVSCaremark starting yesterday, that does not coordinate with Medicare. So I am trying to get the info to determine whether my pharmacy plan copay or Medicare 20% is the better deal. Hmmm, if I call Medicare, will they tell me their approved amount? Somehow I don't think so.


Since this is all new to me I don't know the answers. I couldn't get the DME dept of Prescription Solutions today because of the holiday. I do know that my secondary will pick up the other 20% but I don't know what the actual numbers are.


--------------------
Arlene S.
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Pumped with Minimed 1993-2014
MM CGMS 2006-2014
Dexcom G4, June 2014
t:slim, June 2014
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GA Hiker
post Jan 3 2012, 01:50 AM
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QUOTE(Arlene S. @ Jan 2 2012, 11:58 AM) *
Since this is all new to me I don't know the answers. I couldn't get the DME dept of Prescription Solutions today because of the holiday. I do know that my secondary will pick up the other 20% but I don't know what the actual numbers are.

My local RiteAid pharmacist says he will find out for me. Perhaps by tomorrow. I'll also call Prescription Solutions.
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Arlene S.
post Jan 3 2012, 03:02 AM
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QUOTE(GA Hiker @ Jan 2 2012, 08:50 PM) *
My local RiteAid pharmacist says he will find out for me. Perhaps by tomorrow. I'll also call Prescription Solutions.


I need to call Prescription Solutions about strips. If they can't send One-Touch I'll have to go elsewhere. I do have enough insulin to last for a while. I filled as many prescriptions as I could before the end of the year.


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Arlene S.
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Arlene S.
post Jan 3 2012, 05:08 PM
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QUOTE(GA Hiker @ Jan 2 2012, 08:50 PM) *
My local RiteAid pharmacist says he will find out for me. Perhaps by tomorrow. I'll also call Prescription Solutions.


You can get the insulin from Prescription Solutions but not One=touch strips.


--------------------
Arlene S.
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GA Hiker
post Jan 3 2012, 06:37 PM
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QUOTE(Arlene S. @ Jan 3 2012, 12:08 PM) *
You can get the insulin from Prescription Solutions but not One=touch strips.

I called Prescription Solutions. They cannot tell me anything about what it will cost me. They can only process an order and I would find out when I receive the Medicare EOB, or look online on Medicare after the claim is processed. Since my secondary insurance is not a "Medigap" policy, based on the way they process test strip orders that Medicare has covered (they don't pay on that because they want me to order through the "pharmacy benefit," with a copay larger than 20% of Medicare's approved amount), they will most likely not cover. They are my next call. I'm still waiting to hear from the local pharmacy.
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GA Hiker
post Jan 3 2012, 10:21 PM
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I called my secondary insurance, UHC, and was told that they will not coordinate with Medicare on insulin. So my choice is to buy through Medicare and pay the 20% myself, or go through my pharmacy coverage and pay the copay. Still waiting to find out what the Medicare 20% will be.
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Arlene S.
post Jan 4 2012, 05:00 AM
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QUOTE(GA Hiker @ Jan 3 2012, 05:21 PM) *
I called my secondary insurance, UHC, and was told that they will not coordinate with Medicare on insulin. So my choice is to buy through Medicare and pay the 20% myself, or go through my pharmacy coverage and pay the copay. Still waiting to find out what the Medicare 20% will be.


If I remember correctly yours is not a Medigap or a Medicare supplement. I also have UHC but it's the supplement but I will check with them anyhow. I called Medtronic today and spoke to a very helpful efficient rep who set up my account, deleting my last year's insurance and setting up my new policies. He put me on hold as he got his team to fax my endo for all the information. Since Prescription Solutions does not carry One Touch strips (in their DME department) I am getting my strips from Medtronic. To make sure that everything is in place I went to my endo's office and brought my insurance cards so they could change my insurance. The doctor's assistant saw me and came running out with a folder. She said they faxed all the info to MM. It included the request for increased strips, pump supplies. They also sent my C-Peptide results and the doctor's notes. She said they might require another C-Peptide, which doesn't make sense. That's not what the MM told me. But she did tell me that they may make me get another A1c because I get my blood work done through my PCP and Medicare might require an A1c ordered by my endo. No problem in the future but I just had it done last month. I was very amused when the MM rep told me I'd be receiving a welcome kit. After 18 years of dealing with MM, it's about time they welcomed me.


--------------------
Arlene S.
Type 1
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MM CGMS 2006-2014
Dexcom G4, June 2014
t:slim, June 2014
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GA Hiker
post Jan 4 2012, 01:14 PM
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QUOTE(Arlene S. @ Jan 4 2012, 12:00 AM) *
If I remember correctly yours is not a Medigap or a Medicare supplement. I also have UHC but it's the supplement but I will check with them anyhow. I called Medtronic today and spoke to a very helpful efficient rep who set up my account, deleting my last year's insurance and setting up my new policies. He put me on hold as he got his team to fax my endo for all the information. Since Prescription Solutions does not carry One Touch strips (in their DME department) I am getting my strips from Medtronic. To make sure that everything is in place I went to my endo's office and brought my insurance cards so they could change my insurance. The doctor's assistant saw me and came running out with a folder. She said they faxed all the info to MM. It included the request for increased strips, pump supplies. They also sent my C-Peptide results and the doctor's notes. She said they might require another C-Peptide, which doesn't make sense. That's not what the MM told me. But she did tell me that they may make me get another A1c because I get my blood work done through my PCP and Medicare might require an A1c ordered by my endo. No problem in the future but I just had it done last month. I was very amused when the MM rep told me I'd be receiving a welcome kit. After 18 years of dealing with MM, it's about time they welcomed me.

Correct, my secondary is not a Medigap or Medicare supplement. It is from my retired-from employer and a great deal except in this area. It's amazing to me that when I call UHC I feel like they have never spoken to anyone with Type 1, or anyone on a pump. When I called RiteAid, he had never heard of Medicare covering insulin. I know we are not as common as Type 1s (5% vs 95% of people with D), but I'm still surprised.
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