diabetestalk.net

Are Diabetic Test Strips Covered Under Medicare Part B?

What Diabetic Supplies Are Covered By Medicare? - Medicare Faqs

What Diabetic Supplies Are Covered By Medicare? - Medicare Faqs

What Diabetic Supplies Are Covered by Original Medicare? Original Medicare Part B covers some diabetic supplies, including: Blood glucose monitors, lancet devices, and lancets Glucose control solutions for checking the accuracy of test strips and monitors Insulin if you are using a medically necessary insulin pump (see below) There may be coverage limits on the quantity and frequency you can get these supplies. Original Medicare Part B does not cover these diabetic supplies: Insulin (unless used with an insulin pump) If you use a medically necessary external insulin pump, the insulin and the pump could be covered as durable medical equipment (DME). If you do not use a pump, you pay for all of your insulin costs. If you have Medicare prescription drug coverage (Medicare Part D), insulin and certain medical supplies used to inject insulin are covered. Medicare Part B coverage includes therapeutic shoes or inserts fordiabeticswho have certain conditions ask the doctor who treats your diabetes if you need them. To make sure these supplies are covered by Medicare, please note: A qualified doctor (such as a podiatrist) must prescribe the shoes or inserts. A qualified doctor (such as an orthodontist) must provide and fit you for the shoes or inserts. Medicare Part B covers one pair of custom-molded shoes (including inserts) or one pair of depth-inlay shoes per calendar year. Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for depth-inlay shoes. In certain cases, shoe modifications may be substituted for inserts. The supplier must have an order (prescription) on file signed and dated by the treating doctor; if you switch to a different supplier, you may need to have your prescription Continue reading >>

Medicare And Diabetes: What Is Covered?

Medicare And Diabetes: What Is Covered?

Medicare is the federal health insurance program for people age 65 and older as well as people under age 65 with disabilities and those living with End-Stage Renal Disease. Original Medicare, the most common way to receive Medicare is comprised of part A and part B. Part A is hospital insurance and will cover most medically necessary hospital, home health, skilled nursing facility, and, hospice care. Part B is medical insurance paid for by a monthly premium and covers most medically necessary doctors’ services, durable medical equipment, preventive care, hospital outpatient services, lab tests, x-rays, mental health care, and some home health and ambulance services. You can choose to also get Medicare Part D which is prescription drug insurance and is provided only through a private insurance company that has a government contract. There is also the alternative option to get a private Medicare plan called a Medicare Advantage Plan or Medicare Part C, which generally includes Part D coverage. The Medicare Plan A deductible for 2017 is $1,316 and depending on how long your stay is, you may have to pay an additional amount. The Plan B monthly premium for most Americans in 2017 is $109, though people pay more depending on income level. You can find out your monthly premium by calling Social Security at 1-800-772-1213. You may also have to pay a deductible for Part B. In 2017 the Part B deductible is $183 and after you pay the deductible Medicare pays 80 percent of the Medicare-approved cost of your medically necessary supplies and services. You would pay the 20 percent coinsurance payment. Once the deductible has been met, you cannot be charged to pay more than your 20 percent coinsurance amount and this is the case whether you pick up your diabetes supplies at a local st Continue reading >>

Medicare’s National Mail-order Program For Diabetes Testing Supplies

Medicare’s National Mail-order Program For Diabetes Testing Supplies

Medicare has a National Mail-Order Program for diabetes testing supplies (like test strips and lancets). No matter where you live, you'll need to use a Medicare national mail-order contract supplier for Medicare to pay for diabetes testing supplies that are delivered to your home. If you don't want diabetes testing supplies delivered to your home, you can go to any local pharmacy or storefront supplier that's enrolled with Medicare and buy them there. The National Mail-Order Program doesn't require you to change your testing monitor. If you're happy with your current monitor, look for a mail-order contract supplier or local store that can provide the supplies you need for your monitor. If you switch suppliers, you might need to arrange to have your current prescription transferred or get a new prescription for testing supplies from your doctor. Plan ahead before you run out of supplies. How much will I pay if I buy supplies at a store? You'll pay the same amount for diabetes testing supplies whether you buy them at the store or have them delivered to your home. National mail-order contract suppliers can't charge you more than any unmet Part B deductible and 20% coinsurance. Local stores also can't charge more than any unmet Part B deductible and 20% coinsurance if they accept Medicare assignment. Local stores that don't accept assignment may charge you more. If you get your supplies from a local store, check with the store to find out what your payment will be. Find a supplier. The National Mail-Order Program applies to Original Medicare only. If you’re enrolled in a Medicare Advantage Plan (Part C) (like an HMO or PPO), your plan will let you know if your supplier is changing. If you’re not sure, contact your plan. What if I need a specific brand of equipment or su Continue reading >>

Medicare Coverage To Treat Diabetes

Medicare Coverage To Treat Diabetes

Diabetes is a common medical condition in which the body either doesnt make enough insulin or doesnt respond properly to the insulin it makes. A healthy body uses insulin to process sugars, but when there isnt enough insulin in the body, too much sugar stays in your blood. If your blood sugar remains consistently high, your doctor may diagnose you with diabetes. The information contained in this article is for informational purposes only. It should never be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition. Medicare Part BandMedicare Part Dgenerally cover the services and supplies needed to control diabetes. Heres a breakdown of how Medicare covers diabetes. Medicare Part B covers the fasting blood glucose test, which is a diabetes screening. Medicare covers two diabetes screenings each year for beneficiaries who are at high risk for diabetes. High risk factors for diabetes include: high blood pressure, history of abnormal cholesterol and triglyceride levels, obesity, or a history of high blood sugar. If diabetes runs in your family, you may also need regular diabetes testing. Your doctor may also recommend services that Medicare doesnt cover. You generally pay nothing for these diabetes tests if your doctor accepts the amount approved by Medicare for the diabetes screening. However, you may have to pay 20% of the amount approved by Medicare for the doctors visit. If your doctor diagnoses you with diabetes, Medicare covers the supplies you need to control your diabetes, including blood sugar testing monitors, blood sugar test strips, lancet devices and lancets, and blood sugar control solutions. Medicare Part B may cover an external insulin pump and insulin Continue reading >>

Blood Sugar (glucose) Test Strips

Blood Sugar (glucose) Test Strips

How often is it covered? Medicare Part B (Medical Insurance) covers some diabetic test supplies, including blood sugar test strips as durable medical equipment (DME). Who's eligible? All people with Part B who have diabetes are covered. Your costs in Original Medicare If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment: You may need to rent the equipment. You may need to buy the equipment. You may be able to choose whether to rent or buy the equipment. Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. It’s also important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment. If suppliers don't accept assignment, there’s no limit on the amount they can charge you. Competitive Bidding Program If you live in or visit certain areas, you may be affected by Medicare's Competitive Bidding Program. In most cases, Medicare will only help pay for these equipment and supplies if they're provided by contract suppliers when both of these apply: Contract suppliers can't charge you more than the 20% coinsurance and any unmet yearly deductible for any equipment or supplies included in the Competitive Bidding Program. You may need to use specific suppliers for some types of diabetes testing sup Continue reading >>

We Use Cookies On This Site To Enhance Your User Experience

We Use Cookies On This Site To Enhance Your User Experience

When you have diabetes, accuracy matters. Stick with the brand you trust—don't let them switch your test strips! Some test strip suppliers may tell you otherwise, but Accu-Chek products are still covered by Medicare Part B at the same low co-pay1 as all other brands.2 They may even try switching you to another brand. They’re not concerned about you—they’re doing it to benefit their own bottom line. You can take some simple steps to preserve your choice and ensure you’re not switched to a low-quality product: Say "no," if your strip supplier tries to switch you to another brand. At your next visit, ask your doctor to specify Accu-Chek test strips by name on your prescription. Ask for Accu-Chek strips by name from your test strip supplier. If they no longer carry Accu-Chek test strips, you can purchase them from local retail pharmacies. For a list of retailers that offer Accu-Chek products, visit our Where to Buy page. Get smart answers about Medicare changes Medicare has changed how mail-order customers get diabetes testing supplies. Here's what it means for you. What if my mail-order supplier tells me I need to switch to another brand? You do NOT have to change brands. Patient protection rules exist to help ensure that you have access to the supplies you know and prefer to use. The anti-switching rule requires contract suppliers to furnish the brand of testing supplies that work with the monitor currently in use by the patient. It was established to protect patient and physician choice of glucose monitors. If the supplier you contacted doesn't carry Accu-Chek products, visit your local retailer to purchase your Accu-Chek test strips. Am I required to get my strips through mail order? No. Medicare Part B patients can get diabetes testing supplies from a retail Continue reading >>

Medicare’s National Mail Order Program For Diabetic Testing Supplies

Medicare’s National Mail Order Program For Diabetic Testing Supplies

On July 1, 2013, Medicare Part B will implement a national mail-order competitive bidding program specifically for diabetic testing supplies. [1],[2] The program applies to all zip codes in the 50 United States, the District of Columbia, Puerto Rico, U.S. Virgin Islands, Guam and American Samoa.[3] Once implemented, beneficiaries in traditional Medicare[4] will purchase diabetic testing supplies using a mail order option or a non-mail order option.[5] Included Supplies Equipment such as blood glucose test strips, lancet devices, lancet, and glucose control solutions for checking the accuracy of testing equipment and test strips and other Medicare Part B covered diabetic testing supplies are included in the national mail-order program.[6] However, Medicare Part D-covered supplies such as syringes, needles and inhaled insulin devices are not included in the national mail-order program.[7] Mail-Order Options Under the national mail-order competitive bid program, traditional Medicare beneficiaries will purchase their diabetic testing supplies through a national mail-order contract supplier ("Mail Order Option") or in person from any Medicare-enrolled supplier of non-Medicare testing supplies ("Non-Mail Order Option"). [8] Mail-order supplies will be shipped directly from the supplier to the beneficiary through a service such as United States Postal Service, Federal Express, the United Parcel Service or a mail-order contract supplier's delivery service.[9] Beneficiaries can find suppliers at Medicare Part B will reimburse mail-order deliveries provided that they are delivered directly from the supplier to a beneficiary's residence.[10] Beneficiaries who select the Mail-Order Option cannot have diabetic testing supplies shipped to a pharmacy and then have the pharmacy deliver Continue reading >>

Does Medicare Cover Test Strips?

Does Medicare Cover Test Strips?

I want to compare Medicare Supplement Plans. Or chat about my options with an agent: 1-888-264-0148 Medicare does cover test strips, glucose meters and other essential tools to help monitor diabetes. Original Medicare also helps cover the costs of some other diabetes treatment-related services, such as eye exams and foot exams. Learn more about Medicare coverage for people with diabetes and the associated out-of-pocket costs. MedicarePart B Coverage of Blood GlucoseTesting Supplies If you have Medicare Part B (the medical insurance part of Original Medicare) , youll likely be covered for the costs of test strips. Medicare covers blood glucosetesting strips as a form of durable medical equipment. As such, Medicare will typically pay 80% of the costs of test strips. However, that means certain costs will still be left up to you. These costs may typicallyinclude: 20% of Medicares approved costs of test strips Any portion of Medicare Part B deductible ($183 per year in 2018) that you havent yet paid Medicare Covers SomeOther DiabetesTreatments Blood sugar monitoring and control devices It's important to note that in order for Medicare to coversome diabetes testing supplies, you may need to go through specific durable medical equipment suppliers who are enrolled in Medicare. Additionally, Medicare Part B covers some diabetes services. These can include: With most of the services and diabetes treatment devices listed above, your Medicare Part B coverage will include out-of-pocket costs including the above-mentioned Part B deductible and coinsurance. One way to get some help covering these costs is to purchase a Medicare Supplement Insurance plan . These policies are sold by private insurers and are also known as Medigap policies, since they help pay for some of the gaps in c Continue reading >>

Are Diabetic Test Strips Usually Covered By Insurance? - Agingcare.com

Are Diabetic Test Strips Usually Covered By Insurance? - Agingcare.com

Are diabetic test strips usually covered by insurance? They are covered as long as the doctor writes a prescription for them. They are under Part B of Medicare. A few pharmacies only work with Part D and not Part B. If your pharmacy does not work with Part B, switch to one that does so the diabetic testing supplies will be covered. Most pharmacies will work with Part B, so it is rarely a problem. I am not aware such point. Can you please name a few pharmacies that work with Part B of Medicare. I need the solution for my grandmother. Let me add that some health insurance companies have preferred diabetic supply companies. You can order online, by mail or phone and they ship to your door free of charge. They just need a prescription from your doctor. You get huge savings, IMO. I'm not sure if I'm allowed to say the name of the company, but if you google, diabetic supplies in Twinsburg, OH you should find it. I've used them for years and it's much less expensive than buying them from a pharmacy. My mother has used 4 different pharmacies since I've been here. Three of these will file Part B. One of them stopped for some reason, so we switched over to our current pharmacy in the Health Mart chain. They will file Part B for her diabetic testing supplies. QVC and Walgreen also did Part B. Just ask the pharmacy how they handle Part B for diabetic testing supplies, then select a pharmacy who handles it. Jessie beat me to it but follow her advice as well as Sunny for more savings. I agree ask the pharmacy and you could ask the doctor who they work with as well. One thing to consider is that if you can get part D for prescription coverage open enrollment is available now but ends on Dec 7th. Might be worth checking into. Either way, you should be able to get it. I did this for mo Continue reading >>

Medicare And Diabetes

Medicare And Diabetes

Diabetes is a health condition that affects millions of Americans, including many Medicare beneficiaries. It’s also a condition that sometimes requires a lot of monitoring, so coverage is important when it comes to Medicare and Diabetes. Fortunately, Medicare offers robust coverage related to diabetes, especially when paired with a Medigap plan. Most of the treatment related to diabetes falls under Parts B and D, although Part A will provide hospital coverage for any inpatient stays related to diabetes. In this post, we’ll discuss various aspects of Medicare and Diabetes care. Be sure not to miss my comments below about common billing problems regarding diabetes supplies so you can learn how to avoid them. What Medicare Part B Covers for Diabetes Part B is your outpatient insurance, and it covers a vast array of services for diagnosing and treating diabetes. Let’s break them into sections to make it easier for you to learn. Medicare Screenings and Prevention for Diabetes All people on Medicare get coverage for an initial Welcome to Medicare physical exam. Afterward, they also qualify for an annual wellness visit. During these visits, Medicare Part B will cover preventive screenings, such as the fasting blood glucose test, to people at risk of developing diabetes. Conditions that put you at high risk for diabetes include older age, high blood pressure or cholesterol, obesity, cardiac disease or history of high blood sugar. A family history of diabetes is also considered a risk factor. When your doctor orders a screening test for you, Part B will cover up to two screenings per year. These screenings are covered 100% by Part B. Medicare Part B can also provide screenings for dyslipidemia, impaired glucose tolerance, high fasting glucose, and the very common hemoglobi Continue reading >>

Diabetes Supplies, What Medicare Covers

Diabetes Supplies, What Medicare Covers

HEALTH FEATURE ARCHIVE Diabetes Supplies: What Medicare Covers 1. Self-testing equipment and supplies: Medicare Part B covered diabetes supplies: Coverage for glucose monitors, test strips, and lancets. Who is covered: All people with Medicare who have diabetes (insulin users and non-users). Medicare covers the same supplies for people with diabetes whether or not they use insulin. These include glucose testing monitors, blood glucose test strips, lancet devices and lancets, and glucose control solutions. There may be some limits on supplies or how often you get them. For more information about diabetic supplies, call your Durable Medical Equipment Regional Carrier. How to get your diabetes equipment and supplies: To get your diabetes equipment and supplies under Medicare, you need a prescription from your doctor. The prescription should say: You have been diagnosed with diabetes. How many test strips and lancets you need in a month. What kind of meter you need. For example, if you need a special meter for vision problems, the doctor should say that and state the medical reason why you need a special meter. Whether you use insulin or not. How often you should test your blood sugar. Points to remember: Ask your doctor or health care provider if regular blood sugar testing is right for you. You need a prescription from your doctor to get your diabetes equipment and supplies under Medicare. Learn the correct way to use your blood sugar meter properly. Your pharmacist, doctor, diabetes educator, or another health care provider can help you. Keep track of your blood sugar readings and share them with your doctor or health care provider at regular visits. Do not accept shipments of diabetes equipment and supplies that you did not ask for. 2. Therapeutic shoes: Medicare also c Continue reading >>

Have Diabetes? Medicare Parts B And D Have You Covered

Have Diabetes? Medicare Parts B And D Have You Covered

If you have diabetes, you know it’s a day-to-day reality that needs to be attended to. Making wise food choices, eating at regular times and testing your blood glucose are just a few of the self-care behaviors you may need to master. Medicare supports your self-care efforts by providing coverage for diabetes supplies and services. Medicare Part B covers testing and other supplies you may need plus some medical and education services. Medicare Part D covers diabetes medications and supplies for injecting or inhaling insulin. In general, you pay 20% of the Medicare-approved amount for diabetes supplies and services covered by Part B after the yearly deductible is met. Your percentage share of the cost is called coinsurance. You may pay a coinsurance amount or a copayment for items covered by Part D. A co-payment is a small set dollar amount that you pay each time you receive a service or fill a prescription. What you pay depends on the terms of your specific Part D plan. Some services, such as medical nutrition therapy and hemoglobin A1c tests (HbA1c), may be provided at no additional cost to you. Here’s a rundown of the diabetes supplies and services that Medicare covers. Medicare Part B-covered items include: Blood glucose testing supplies and equipment (meters, test strips, lancets and control solutions) Therapeutic shoes or inserts Insulin pumps and insulin used with a pump Diabetes screening tests for people at risk Diabetes self-management training to learn how to help manage diabetes day-to-day Medical nutrition therapy, including diet and lifestyle counseling Hemoglobin A1c tests to monitor blood glucose control Foot exams and treatment for diabetes-related nerve damage Eye test for glaucoma Medicare Part D-covered items include: Medications to manage blood gl Continue reading >>

Coverage Of Diabetic Testing Supplies For Dual Eligibles

Coverage Of Diabetic Testing Supplies For Dual Eligibles

Coverage of Diabetic Testing Supplies for Dual Eligibles We frequently hear from dual eligibles (people who have Medicare and Medicaid) who have problems getting their diabetic testing supplies at their local pharmacy or who end up being charged more than they should for these items. As a result, we want to review how coverage for these items works when someone has both insurances and gets their diabetic testing supplies at a local pharmacy. Diabetic testing supplies include test strips and lancets which are used to test the blood sugar level in people who have Diabetes. Unlike insulin and needles that are covered solely by Medicare Part D, testing supplies are covered by Medicare Part B. When people get these items at a local pharmacy, the pharmacist should bill their Medicare coverage first (either Original Medicare or their Medicare Advantage plan). Then, the pharmacist should bill the ACCESS card second. After billing both insurances, a dual eligible should only be charged a very small Medicaid co-pay (no more than $3 for each item). In some cases, there may not be any co-pay. Pharmacists who are having problems getting Medicaid (ACCESS) to pay second for test strips and lancets should call the Medicaid Pharmacy Services Provider Call Center at 1-800-537-8862, select Option 1 and then Option 1 again. Dual eligibles who experience problems getting their diabetic testing supplies at the pharmacy can call Pennsylvania Health Law Projects Helpline at 1-800-274-3258 for assistance. Continue reading >>

Cvs/pharmacy Reminds Patients With Diabetes About The Importance Of Regular Testing To Help Manage Their Disease

Cvs/pharmacy Reminds Patients With Diabetes About The Importance Of Regular Testing To Help Manage Their Disease

WOONSOCKET, R.I., May 20, 2013 /PRNewswire/ --CVS/pharmacy is reminding patients with diabetes that one of the most important ways they can manage their disease is to perform regular testing of their blood sugar (glucose) levels. While the number of providers that will accept Medicare coverage for diabetes testing supplies is expected to decline after July 1, 2013 due to Medicare changes, CVS/pharmacy is informing those treating diabetes it will continue to accept Medicare Part B coverage for test strips and other diabetes testing supplies. The Company has more than 7,400 locations in the U.S. and stocks all major brands of diabetes supplies. "More than 25 million people in the United States have diabetes and every 17 seconds, another American is diagnosed with diabetes, so it is critical that patients continue to have affordable access to diabetes testing supplies to help them manage their disease," said Papatya Tankut, RPh, Vice President of Pharmacy Affairs at CVS Caremark. "CVS/pharmacy is committed to ensuring that Medicare patients can use their insurance coverage for test strips and other diabetes supplies. We also offer 90-day supplies of prescription test strips at the same low price as mail order." CVS pharmacists are available every day as a resource for patients with diabetes who need advice or who have questions about prescription and over the counter medications to manage their disease. CVS/pharmacy can also assist patients with any new paperwork from their doctor's office that is required by the changes Medicare is making to coverage of diabetes testing supplies. Another resource CVS/pharmacy offers patients with diabetes is the ExtraCare Advantage for Diabetes program, which has helped more than 2 million members save money and better manage the disease Continue reading >>

Does Medicare Cover Diabetes Supplies

Does Medicare Cover Diabetes Supplies

| Licensed since 2008 Print Are you looking for ways to manage your costs for diabetes supplies? In addition to any medications your doctor prescribes, like insulin, you also could have costs related to daily blood glucose monitoring. Fortunately, if you are enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage plan, you may have coverage for some of your diabetic supplies and equipment. Here’s a summary of your benefits. Please note that this article refers to Medicare Part B. If you’re enrolled in a Medicare Advantage plan, you still get all the benefits of Medicare Part B (along with Part A benefits, all except for hospice care – which is covered for you under Medicare Part A). If you have questions, contact your Medicare Advantage plan. Does Medicare cover diabetes supplies for blood glucose testing? Diabetic supplies for blood glucose monitoring are considered durable medical equipment (DME) under Medicare Part B. In order for your diabetes supplies to be covered, they must be ordered and supplied by providers who participate in the Medicare program. In addition, in some parts of the country, Medicare has launched a new competitive bidding program for DME to help lower costs for these items. If you live in one of these areas, you must get your diabetic supplies from a contracted provider or Medicare may not pay for them. Part B may pay 80% of allowable charges for glucose monitors, glucose control solution, diabetic test strips, and lancets and lancet devices; you then generally pay 20% plus any applicable deductibles. There may be quantity limits on the number of test strips and lancets Medicare covers each month (usually 300 of each every three months if you use insulin, or 100 of each if you don’t).However, your doctor may request an Continue reading >>

More in insulin