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What Brand Of Diabetic Supplies Are Covered By Medicare?

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 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 >>

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 >>

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 >>

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 >>

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 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’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 >>

Diabetes Drugs And Supplies Covered By Medicare Part D

Diabetes Drugs And Supplies Covered By Medicare Part D

Medicare Part D provides coverage for a range of diabetes supplies, including insulin, anti-diabetic drugs and certain medical supplies. Eligible individuals enrolled in Medicare Part D pay monthly premium and co-payments. They also must meet a yearly deductible before their prescription drugs are covered. Diabetes drugs covered by Medicare Part D Medicare Part D is very specific about what medications are covered for diabetes. These include anti-diabetic drugs and insulin. Anti-diabetic drugs include medications in the following four categories: Alpha glucosidase inhibitors, such as Precose Thiazolidinediones, such as Prandin and Starlix The list of diabetes medications allowed under Medicare Part D can change, so always check with a health care provider for the most up-to-date coverage information. Medicare Part D also covers insulin delivered in vials or pens. However, it does not cover insulin used with an infusion pump. Insulin that is taken with a pump is covered by Medicare Part B. Diabetes supplies covered by Medicare Part D Medicare Part D also covers the supplies necessary to take insulin by inhalation or injection. Covered supplies include syringes, needles, alcohol swabs, gauze pads, insulin pens and inhaled insulin devices. The diabetes supplies covered under Part D include only those necessary to take insulin. Supplies necessary to test blood sugar or otherwise control and monitor diabetes fall under the coverage of Medicare Part B. How the donut hole affects the cost of diabetes drugs and supplies The 'donut hole' is a term used to describe the gap in coverage for those who have basic Medicare Part D. Here's how it works: Covered individuals pay 100 percent of the cost of their prescription drugs until their deductible is reached. After they have met the 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 >>

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 >>

I Have Diabetes. Can I Get My Blood Sugar Testing Supplies And Blood Glucose Monitor Covered By Scan?

I Have Diabetes. Can I Get My Blood Sugar Testing Supplies And Blood Glucose Monitor Covered By Scan?

Yes. SCAN covers diabetes testing supplies, but please pay attention to the brands and specific products we cover, which are listed in our Formulary: (Abbott) Freestyle brand blood glucose monitors, test strips and control solution and any brand of lancets and lancet devices/kits for testing your blood sugar, including those produced by Accu-Chek and One Touch. Simply have your doctor write a prescription for your supplies, and then get the prescription filled at any SCAN network pharmacy. Testing supplies are also available from Express Scripts, SCAN’s Mail Order Pharmacy. Continue reading >>

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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 >>

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 >>

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 >>

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