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Medicare Approved Diabetic Suppliers

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 >>

Alleviating The Confusion Over New Changes Around Diabetes Supplies

Alleviating The Confusion Over New Changes Around Diabetes Supplies

The Medicare rules for ordering diabetes supplies through a mail-order pharmacy have changed. Here is the information you need to know to make this transition smoothly. On July 1, a Medicare rule took effect that impacts beneficiaries who get their diabetes testing supplies via mail order. It’s referred to as the Medicare National Mail-Order Program. Under the new ruling, beneficiaries must buy their diabetes supplies, including blood glucose trips, lancets, lancet devices, batteries and control solution, through a list of designated vendors, or Medicare national mail-order contract suppliers. Beneficiaries who pick up their testing supplies from a local pharmacy can still do so, but they need to make sure that the store accepts Medicare "assignment" to avoid higher charges for the supplies. At Joslin Diabetes Center, we are closely monitoring this new program which is intended to be a cost-cutting measure. If you have questions or difficulties navigating the new system, we provided you with additional details to ensure the program is not a disruption to your diabetes care. Who is affected? Medicare beneficiaries in all 50 states, D.C., Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa, who have Original Medicare, are impacted. These changes do not apply to Medicare Advantage plans (like an HMO or PPO). If you are enrolled in a private plan through Medicare, you can contact your plan to find out which suppliers you can use. How can I get my supplies? If you want diabetes testing supplies delivered to your home, you must use an approved Medicare national mail-order contract supplier in order for Medicare to help pay for the supplies. To find a contract supplier, you can call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov/supplier. Alternatively, Continue reading >>

Does Medicare Cover My Diabetic Testing Supplies?

Does Medicare Cover My Diabetic Testing Supplies?

The simple answer is that yes, Medicare does cover some diabetic supplies. Medicare covers diabetic testing supplies, such as: Glucose Test Strips Blood Sugar Testing Monitors Lancets Glucose Solution Avoid the Most Common Pitfalls When Buying Diabetic Supplies Many people who are new to Medicare and/or diabetes care do not realize that in order for diabetic supplies to be covered by Medicare, a prescription is required from your doctor. If you buy diabetic supplies over-the-counter without a prescription, you have to pay full price. In addition, you should purchase your diabetic supplies at the pharmacy counter (as opposed to the general retail counter) because the pharmacy has the ability to process the claim with Medicare. Also, keep in mind that Medicare will not pay for supplies if you go to a pharmacy that is not enrolled in Medicare. The Most Complete Insurance Coverage: Medigap Plan F To ensure that your insurance covers the cost of diabetic supplies, such as diabetic meters, lancets, and test strips, we recommend enrolling in excellent health insurance coverage, which includes: Medicare A & B A good Medicare Part D plan & Medicare supplement Plan F You can protect yourself from against high out-of-pocket costs by enrolling in a full coverage Medicare supplement plan, such as the Medigap Plan F policy, which covers 100% of Medicare Part B’s excess charges. It is the most comprehensive Medicare supplement plan because it covers ALL the gaps left by Medicare A & B. Without a Medicare supplement Plan F, you will most likely be responsible for the Part B deductible ($183 deductible in 2018) and any required coinsurance or copays. You should not be required to pay any out-of-pocket costs if you have Medicare A & B, Medicare Part D, and Medigap Plan F. How to Minimi Continue reading >>

Medicare Coverage For Diabetes Services And Supplies

Medicare Coverage For Diabetes Services And Supplies

Diabetes is a condition where your body lacks the ability to use blood glucose (blood sugar) for energy, according to the Centers for Disease Control (CDC). As a result, diabetics may have high blood glucose levels. In diabetics, the pancreas typically doesn’t make or use the insulin hormone efficiently. Your body uses insulin to turn sugar (glucose) into energy. Unused sugar can build up in your blood and cause both short-term and long-term problems. Diabetes can be diagnosed with a simple blood test. Many older Americans have type 2 diabetes, where your body doesn’t produce enough insulin or develops resistance to it, according to the CDC. However, even adults can get type 1 diabetes, which used to be called juvenile diabetes. Medicare covers certain medical services and supplies for individuals who have diabetes or at risk for this condition. Medicare coverage for diabetes screenings If you have Medicare and your doctor considers you at risk for diabetes, you may be eligible for up to two blood sugar screenings per year under Medicare Part B ; you don’t pay anything for the screening itself if you use a Medicare-assigned provider at a Medicare-approved facility. However, you may have to pay 20% of the Medicare-approved amount for the visit to the doctor’s office. Risk factors that may qualify you for a Medicare-covered diabetes screening include: High blood pressure History of abnormal cholesterol and triglyceride levels Obesity History of high blood sugar Family history of diabetes Older age (risk for type 2 diabetes increases with age) Reduced blood sugar tolerance High blood sugar levels when fasting Medicare coverage for diabetes patients If you’re diagnosed with diabetes, Medicare may cover services and supplies you will need to treat and control diabe Continue reading >>

Social Security & Medicare Questions: Diabetes Supplies Delivery

Social Security & Medicare Questions: Diabetes Supplies Delivery

Social Security & Medicare Questions: Diabetes Supplies Delivery Q: I'm diabetic and get my blood testing supplies via mail order.When I called to order my next shipment I was told I would have to pay the full cost of supplies and my credit card was charged.I thought Medicare covered the cost. A:Medicare has begun a major program change that affects diabetics who get supplies home delivered and other seniors who rent medical equipment like home oxygen gear and wheel chairs. The program is intended to help seniors save money when they buy supplies and rent equipment, but TSCL believes it is more likely to first cause confusion and surprise unanticipated costs until patients figure out the new system. Adding to the confusion, the program will affect beneficiaries differently depending on the area of the country in which they live, and how they are getting their supplies and durable medical equipment. Effective July 1, 2013, in most cases if you have "Original" Medicare coverage and get items in the new program areas, Medicare will only help pay for these items if theyre provided by contract suppliers. If you buy your diabetic testing supplies through mail order, you MUST get your supplies through contract suppliers in Medicare's new National Mail Order Program in order for Medicare to pay. This applies to beneficiaries living in all parts of the United States.Medicare defines mail order as all home deliveries. National mail order contract suppliers can't charge you more than any unmet deductible and 20 percent coinsurance.To find a contract supplier for your area, call 1-800-MEDICARE (1-800-633-4277), or visit www.medicare.gov/supplierdirectory . The online tool will allow you to select the type of supplies you need and provides a complete list of mail order suppliers an Continue reading >>

Medicare Starts Mail-order Program For Diabetes Supplies

Medicare Starts Mail-order Program For Diabetes Supplies

Health & Wellness | Thu, Jul 11, 2013 @ 09:00 AM Medicare Starts Mail-Order Program for Diabetes Supplies Medicare started a national mail-order program for diabetes supplies on July 1, 2013. The program contracts with specific suppliers, which were selected based on a competitive bidding process. If you have Original Medicare, you may need to get your home-delivered test strips from a contracted supplier in order for Medicare to cover them. Contracted suppliers must accept Medicares approved amount as payment in full for diabetes supplies. They can charge you only the 20% coinsurance, once you meet your deductible. The amount Medicare will pay suppliers for test strips will be lower starting on July 1. That means that the coinsurance amount you pay will likely be less as well. The mail-order program is in effect in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam and American Samoa. It applies only to people who have Original Medicare. If you have a Medicare Advantage plan, contact your plan for more information. Its important to find out whether your current mail-order supplier is a Medicare contract supplier. If it is, then thats great. You can just keep on as usual. If your mail-order supplier is not contracted with Medicare, then Medicare will not cover what you buy. You need to find a contracted mail-order supplier that sells the strips you use. To change suppliers, you can usually just transfer your existing prescription to the new supplier. In some cases, you may need a new prescription. You can visit Medicares online Supplier Directory to see if your current supplier is contracted. Just enter your zip code. If you dont see your supplier there, you can look for another one to use. Some pharmacies and stores stock and sell diab 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 >>

Medicare Coverage Of Diabetic Services And Supplies

Medicare Coverage Of Diabetic Services And Supplies

Medicare Coverage of Diabetic Services and Supplies Medicare covers many diabetic services, if they are delivered by a doctor or other provider who accepts Medicare assignment. Medicare also covers a range of common diabetic supplies when theyre considered medically necessary. Different parts of the Medicare program cover the various aspects of diabetic treatment. What do Medicare Part B and Medicare Advantage plans cover? Medicare Part Bcovers diabetic test supplies, screenings, and education for beneficiaries with diabetes, or for those who are at risk for diabetes. Medicare Advantage, also called Medicare Part C, is optional private insurance. Medicare Advantage plans cover the same diabetic supplies and screenings that Medicare Part B covers. Medicare Advantage plans are required to provide at least the same amount of coverage as Original Medicare (Part A and Part B), except for hospice care. Medicare Part B covers diabetic supplies such as: Therapeutic shoes or sole inserts, if you meet all of these conditions: You have diabetes and youre being treated under a comprehensive diabetes care plan. You need therapeutic shoes or inserts because of your diabetes. In one or both feet, you have any of these: poor circulation, past foot ulcers, calluses that could lead to foot ulcers, deformity, nerve damage and potential callus problems because of diabetes, or partial or complete amputation. If you get therapeutic shoes or inserts, a podiatrist or other qualified doctor must prescribe them, and a doctor or other qualified individual like a pedorthist, orthotist, or prosthetist must fit and provide the shoes or inserts. Medicare Part B covers diabetic services such as: Up to two diabetes screenings each year if your doctor indicates youre at risk for diabetes. After the fir Continue reading >>

Prodigy® Diabetic Supplies – Medicare And Insurance Coverage

Prodigy® Diabetic Supplies – Medicare And Insurance Coverage

Blood glucose testing is an important part of diabetes management. Most insurance companies and Medicare/Medicaid will pay for blood glucose testing supplies. With private insurance or managed care, patients will most likely be asked to pay a co-pay to cover part of the cost of the supplies. Medicare pays for 80% of supplies once the patient has met their yearly deductible and the patient is responsible for the remaining 20% of the cost. See the www.Medicare.gov site for a full explanation of how your blood glucose testing supplies are covered. Prodigy Diabetes Care is contracted with certain insurance providers and state Medicaid programs, which may make the Prodigy brand products available to those individuals at a lower co-pay or no co-pay depending on the program. Continue reading >>

Medicare Changes Create Uncertainty For Diabetes Supplies

Medicare Changes Create Uncertainty For Diabetes Supplies

Medicare Changes Create Uncertainty for Diabetes Supplies A major change in US Medicare reimbursement rules beginning July 1 will save money but will drastically limit the number of vendors from which beneficiaries with diabetes can obtain glucose-testing supplies. There are fears in some quarters that this disruption may lead to people not accessing the supplies they need, resulting in a decline in self-monitoring of glucose and subsequent adverse outcomes. However, others stress that diabetics receiving Medicare will gain financially, as their copays for their supplies will drop. Independent retail pharmacies are also concerned: they believe the price cuts will mean many of them will drop out of providing these services, with the resulting loss of face-to-face interactions between pharmacists and patients, which can be of immeasurable benefit, they say. And patients may be forced to switch to lower-quality products, they charge. But proponents of the changes stress that the new rules do not force beneficiaries to switch brands, although they acknowledge that not all suppliers will carry all the brands. The American Diabetes Association (ADA), US Centers for Medicare and Medicaid Services (CMS), and Diabetes Care Club (DCC) have all posted information on their websites to help beneficiaries and physicians understand and negotiate the new program. ADA: Ensure Glucose Self-Monitoring Not Disrupted Part of the new plan the nationwide Medicare National Mail Order Program will mean that diabetic beneficiaries who receive their glucose-testing supplies delivered to their homes will need to obtain them from 1 of 18 contract suppliers chosen by Medicare via a competitive bidding process. People who prefer to buy their supplies at retail stores can still do so, but they need t Continue reading >>

Medicare Limitations On Diabetes Supplies Endanger Patients

Medicare Limitations On Diabetes Supplies Endanger Patients

Medicare Limitations on Diabetes Supplies Endanger Patients The Medicare Competitive Bidding Program presents patient safety risks by limiting diabetes testing supply choices, a new survey contends. -Medicares Competitive Bidding Program (CBP) may increase the risk of negative patient safety events or medication nonadherence for diabetics by limiting the variety of available diabetes testing supplies, finds a survey by the American Association of Diabetes Educators (AADE). According to the AADEs research, the number of manufacturers making diabetes testing supplies (DTS) available under the National Mail Order (NMO) system has fallen by 50 percent since the CPBs start in 2009, limiting providers ability to match patients with the best equipment for their needs. Over 65 DTS brands once offered through the NMO are now unavailable. The number of DTS manufacturers offered to Medicare beneficiaries has fallen from 38 to 20. CMS Seeking Feedback on Pediatric Alternative Payment Model Physicians, diabetes educators and other healthcare practitioners often prescribe specific DTS based on the needs of individual patients, along with their experiences with the reliability, performance and features of specific products, the researchers said. For example, some beneficiaries need audible readings or large displays because of poor vision. Providers may recommend DTS that are compatible with their office-based electronic medical record system. Different DTS are not interchangeable. The inability to provide certain brands under Medicare coverage options may increase the risk of diabetes complications, including blindness. Limited options could also push beneficiaries into paying higher costs. When a beneficiary is forced to use a DTS that is unknown, difficult, confusing, or unreliabl Continue reading >>

Medicare Part B

Medicare Part B

#1 Brand used by Medicare patients OneTouch® test strips are ALWAYS covered on Medicare Part B and $0 with most supplemental health plans.* With their red, white and blue Medicare Part B card alone, your patients pay just $1.66 for a box of 50ct test strips. 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 >>

Aade: Medicare Isn't Providing Diabetes Supplies Like It Should

Aade: Medicare Isn't Providing Diabetes Supplies Like It Should

Seems like there's always some new roadblock cropping up to thwart us from getting the diabetes supplies we need… The latest hurdle comes from the beleaguered Centers for Medicare & Medicaid Services (CMS). According to a new survey just released by the American Association of Diabetes Educators (AADE) on Feb. 3 -- surprise, surprise! -- CMS is now limiting patient access to insulin pumps as well as meters, strips and other basic supplies. The results are disturbing, and they add to the already dismal state of affairs at as it pertains to diabetes. Remember that CMS introduced its controversial competitive-bidding process in 2013, requiring PWDs (people with diabetes) on Medicare to choose from an approved short-list of diabetes suppliers to get what they need to survive. First, this limited only glucose meters and strips by mail-order. And then the limits expanded to pharmacies. We were worried, but were reassured by the government and CMS leaders that all would be OK. Yet an initial AADE survey from early 2014 found that the competitive-bidding process was failing PWDs on Medicare who needed mail-order testing supplies. Because CMS is not properly monitoring the companies selected for the bidding process and “the agency has not taken action against suppliers who have changed their offerings since their bids were accepted,” they are getting away with offering customers the cheapest, lowest-quality glucose meters, according to testimony from AADE Chief Advocacy Officer Martha Rinker in the 2014 survey. CMS recently announced inclusion of insulin pumps on the list of medical supplies going through competitive-bidding in nine regions across the country. For the AADE survey conducted last Fall, educators across the country called up a total of 29 different supplies l Continue reading >>

What Diabetic Supplies Are Covered By Original Medicare?

What Diabetic Supplies Are Covered By Original Medicare?

Original Medicare Part B covers some diabetic supplies, including: Blood sugar (glucose) test strips 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) Therapeutic shoes or inserts (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) Insulin pens, syringes, or needles Alcohol swabs or gauze About insulin coverage 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. About therapeutic shoes and inserts Medicare Part B coverage includes therapeutic shoes or inserts for diabetics who 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 (pr Continue reading >>

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