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What Glucose Test Strips Does Medicare Cover?

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 >>

How Can I Get Medicare Coverage For Blood Glucose Test Strips?

How Can I Get Medicare Coverage For Blood Glucose Test Strips?

How can I get Medicare coverage for blood glucose test strips? In order to receive Medicare coverage for blood glucose test strips and related supplies, a prescription must be written by a physician. This prescription must meet the following guidelines: The prescription must be renewed every six months. The prescription must clearly document the number of strips and lancets to dispense. The prescription must document whether or not the patient uses insulin to manage diabetes. The frequency with which the patient should monitor their blood glucose level or use the supplies must be clearly identified. This point is extremely important as Medicare will not accept prescriptions that state monitoring should occur or supplies should be used "as needed." How can I find out if my Medicare application was accepted? You can find out if your Medicare application was accepted by calling the Social Security office or by checking online at www... Does Medicare cover immunosuppressant medication costs after a transplant? Methodist Specialty and Transplant Hospital Medicare will cover 80% of the cost of three immunosuppressant medications after a transplant. If you receive Social Security ... Can I sign up for Medicare Part D at any time? Not really. You can sign up for Medicare Part D (prescription drug coverage) when you first become eligible for Medicare (for ... What happens to my younger spouse when I go on Medicare at age 65? The best option for your spouse, frankly, is for you to work longerif this is at all possibleso that you both can continue ... 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 Coverage Of Glucose Monitors

Medicare Coverage Of Glucose Monitors

| Licensed since 2007 Print What are glucose monitors used for? If you have been diagnosed with diabetes, a glucose monitor can help you manage your disease and prevent complications, according to the National Institutes of Health (NIH). A glucose monitor measures your blood sugar (glucose) levels so you can make informed decisions about eating, exercising, and taking prescription medications, such as insulin. According to the NIH, one way to monitor your glucose levels is by using a finger-stick device to collect a drop of blood, which you put into a glucose monitor on a set schedule each day. An alternative site glucose monitor allows blood samples from areas such as your palm or thigh, according to the Mayo Clinic. As well as a glucose monitor, you may also need other testing supplies, such as lancets, glucose test strips, and a glucose control solution. Medicare coverage of glucose monitors Under Original Medicare (Part A and Part B), Part A covers health-care expenses you incur as an inpatient in a hospital, while Part B covers your outpatient care, including some glucose monitoring supplies and durable medical equipment. Medicare does not generally cover “continuous glucose monitoring,” which (according to the NIH) involves a sensor inserted under your skin for several days to a week. If your health-care provider recommends a different way to monitor your blood sugar other than the finger-stick glucose monitor, you might want to check with Medicare to see whether it’s covered. You can reach a Medicare representative 24 hours a day, seven days a week, if you call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. If you have a Medicare Advantage plan, call your plan to ask about this coverage. How does Medicare treat durable medical equipment Continue reading >>

2 Ways You Could Save On Blood Sugar Test Strips

2 Ways You Could Save On Blood Sugar Test Strips

Blood sugar testing is a way to keep track of how well diabetes is being managed. Test results help to show how food, physical activity and diabetes medications affect blood sugar. The number of blood sugar tests a person with diabetes may do varies. It depends on the treatment plan. Some people test their blood sugar several times a day. Others test less often. Sometimes extra tests may be needed, such as when starting a new medication or adjusting an insulin dose. Every blood sugar test uses a test strip. Every box of strips usually comes with a cost–typically a 20% co-insurance payment after the Part B deductible. It could be tempting to skip tests if strips start to cost too much. Medicare understands how important regular testing is to diabetes self-management. There is now a competitive bidding process that helps Medicare select suppliers that meet its standards for the quality and cost of diabetic supplies. Here are two ways that you can get the blood sugar test strips you need at the lower cost that Medicare’s competitive bidding process offers. 1. Order blood sugar test strips from a Medicare contracted mail-order supplier. Medicare has a mail-order program for diabetic testing supplies. Medicare sets the amount it will pay based on bids from suppliers. Contracted suppliers may not charge you more than 20% co-insurance on the Medicare-approved amount. You can enter your zip code to find a supplier on the Medicare web site. Check the box for “Mail-Order Diabetic Supplies,” then scroll down and click the Search button. You’ll get a list of contracted suppliers. You’ll need to check each supplier to see which ones carry what you need. You can usually transfer your prescription to any supplier. Test strips or other diabetic supplies you order can then b Continue reading >>

Medicare Cost-cutting On Diabetes Test Strips Puts Lives At Risk, Study Finds

Medicare Cost-cutting On Diabetes Test Strips Puts Lives At Risk, Study Finds

The research puts data behind long-simmering complaints from patients and clinicians about availability of diabetes test strips. A competitive bidding program designed to save Medicare money has instead put beneficiaries with diabetes in the hospital, driving up costs for both patients and taxpayers and causing the untimely death of some, according to a study published today in the journal Diabetes Care.1 Study authors called on CMS to halt bidding for diabetes test strips until the program’s flaws can be fixed, with one author saying that the rock bottom prices and lack of standards have left beneficiaries low-quality strips from “off shore” suppliers, which can give inaccurate results. Research by the National Minority Quality Forum puts data behind long-simmering complaints about the availability of diabetes test strips for Medicare patients, which have increased since CMS switched to a competitive bidding program for these critical supplies. Those who use insulin to regulate their diabetes use test strips monitor blood glucose levels several times a day, which help them decide how much insulin they need, to manage their diet, and to avoid episodes of hypoglycemia. CMS started the pilot in 9 test markets in 2011; after CMS declared it a success it was expanded nationwide in 2013. But the study published today reaches a shocking conclusion: armed with the same data available to CMS, the team found that the low reimbursement levels during the pilot program—which fell from $34 to $14 per vial—led to disruptions in supplies, causing some patients to monitor their blood sugar less frequently or not at all. “Based on our findings and employing the safety monitoring protocols commonly used to protect human subjects, we believe policymakers should immediately sus Continue reading >>

Everything You Need To Know About Prediabetes And Diabetes Supply

Everything You Need To Know About Prediabetes And Diabetes Supply

Diabetes is a serious lifelong condition that may cause other major health problems if you do not keep your blood glucose under control. Whether you are a prediabetes candidate or already have diabetes, it is crucial to understand fully what supplies you need in order to monitor and control your blood glucose level, and alleviate various conditions that may exhibit along with the condition. Prediabetes Supply – Things Prediabetics Need Getting diagnosed with prediabetes is a serious wake-up call to your current health, but it doesn’t have to mean you will most definitely get diabetes. With close monitor to your blood glucose level and paying attention to lifestyle changes, you can slow down the progression to diabetes or even prevent diabetes. Physical activity is an essential part of the treatment plan for prediabetes because it lowers blood glucose levels and decreases body fat. Depending on your health insurance company policy, you may be qualified for an incentive for joining a gym or fitness program. If your insurance company does not offer an incentive, you can try asking about your working company policy and see if they have an incentive for their workers getting fit. At the same time, they may offer an incentive for going to a nutritionist and plan out a diet plan for your needs. However, if both your insurance company and your working company both do not offer incentives, you can still claim these expenses as medical expenses on your tax as long as you have documentation of these treatments being recommended by your doctor. Sleep is crucial for prediabetes candidates. Without proper amount of sleep, your body cannot use insulin effectively and may increase your chance of developing type 2 diabetes. If you suffer from sleep apnea, do seek help from your doct Continue reading >>

Diabetes Health Coverage: State Laws And Programs

Diabetes Health Coverage: State Laws And Programs

Diabetes Health Coverage State Laws and Programs Diabetes Health Coverage: State Laws and Programs This is a policymaker and consumer guide to state insurance mandated coverage, Medicaid coverage and state-sponsored diabetes programs. It was published 2011and updated material was added January 2016 All state law diabetes mandates and minimum coverage requirements for state-regulated health insurance policies. The tables include the enacted state laws passedsince the firstmandates inCalifornia (1981) and New York (1993). Use links below to go directly to state-based information: State Medicaid diabetes coverage terms and conditions. All Children's Health Insurance Program (CHIP) diabetes coverage. Contact information and an overview of federal funding provided by the Centers for Disease Control and Prevention (CDC) to state-sponsored diabetes prevention and control programs (DPCPs). DPCPs represent the front line in battling diabetes in most states. An overview of other state activities and initiatives, such as creation of diabetes coordinator positions in the executive branch to fight diabetes. Federal Health Reform.The federal Affordable Care Act (ACA) signed March 2010, has led to changed and expanded coverage termed "EssentialHealth Benefits." Newly Released: NCSL Survey:Diabetes Drug coverage: A new survey of2016 Insurance Plans in 50 states, examining 1) patient access to the scores of diabetes drug treatments and2) results in the 46 states with laws mandating or offering diabetes coverage. NCSL original research, published summer 2016. [Read the report] December 2015: " Diabetes: Addressing the Costs; A 50-State Budget Survey for FY 2014 ." NCSL released its latest diabetes report, taking a closer look at programs and budget appropriations that play a role in con 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 >>

Diabetes Screenings And Supplies

Diabetes Screenings And Supplies

Create your free Medicare Interactive profile, and receive the following great benefits: Bookmark your favorite courses and answers for quick reference, whether counseling a client, helping a family member, or simply brushing up on your Medicare knowledge Receive a free exclusive resource: the New to Medicare Guide Keep track of where you left off in MI Pro courses, and complete coursework at your own pace Become part of a Medicare community and receive key Medicare reminders Receive updates about Medicare Interactive and special discounts for MI Pro courses, webinars, and more Diabetes is a disease that results in high levels of sugar (glucose) in your blood. Diabetes screenings and supplies can help identify, manage, and treat diabetes. Medicare Part B covers an annual diabetes screening, including a fasting blood glucose test and/or a post-glucose challenge test, if you have one of the following risk factors: History of abnormal cholesterol levels (dyslipidemia) Part B also covers an annual diabetes screening if at least two of the following apply to you: Your family has a history of diabetes during pregnancy (gestational diabetes), or you have had a baby weighing nine pounds or more If you have been diagnosed with pre-diabetes, Medicare covers two diabetes screening tests each year. Having pre-diabetes means you have blood glucose levels that are higher than normal, but not high enough to be classified as diabetes. If you qualify, Original Medicare covers diabetes screenings at 100% of the Medicare-approved amount when you receive the service from a participating provider . This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover diabetes screenings without applying deductibles, copayments, or coinsurance when you se 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 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’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 >>

When Do You Need A Prescription For Diabetic Test Strips?

When Do You Need A Prescription For Diabetic Test Strips?

When Do You Need A Prescription for Diabetic Test Strips? Whether or not you need a prescription to purchase diabetic test strips depends on one thing. Read this article to find out how it all works. If you’re one of the 29 million Americans living with diabetes, you likely have a lot of questions about how to get the medication you need. We’re sure you also have questions about how you can keep the costs of supplies, test strips, lancets, and hospital visits down. Even if you’re working out and taking care of yourself, you may feel like you can’t do much to fight back against the rising costs of life with diabetes. In this post, we’ll talk about whether or not you need a prescription to get diabetic test strips. We’ll also talk about how the cost of diabetes is different for the insured and the uninsured diabetes patient. No matter what your coverage is like, it’s always a smart idea to look for bargains, ways to save, and ways to make back some of the money you’ve spent on diabetic test strips. Read this post to learn how to save better. The Costs Of Diabetes: Insured vs. Uninsured There’s no getting around it: life with diabetes is costly. In fact, recent figures show that the average yearly cost for one person living with diabetes is about $13,700. Unfortunately, that same study showed that those without health insurance who are living with a diabetes diagnosis get 68% fewer prescriptions, and 79% fewer doctor visits, than those that are insured. Though most states have made sure insurance companies are required to cover medical costs and supplies, you still have to do a good amount of work to get certain things covered by your plan. You may even have to write them letters just to make back a small portion of what you spend on supplies like diabeti Continue reading >>

Professional + Long Term Care

Professional + Long Term Care

Many health insurance plans and Medicare cover much of the cost of diabetes testing supplies, including blood glucose monitors and test strips. Private Insurance Coverage The cost of diabetes testing supplies are covered by many private insurance and managed healthcare plans. It's possible that a portion or all of your diabetes treatment and supplies will be covered under your plan. To determine your coverage, talk to your insurance provider. What is Medicare? Medicare is a federal health insurance program for United States Citizens over 65 years of age, permanently disabled people under the age of 65, and people with end-stage renal disease (ESRD). Medicare Part A and B Medicare Part A - Hospital Insurance (HI) that pays for inpatient hospital care and skilled nursing facility care. Hospice care and some home healthcare is also covered. Medicare Part B - Supplemental Medical Insurance (SMI) that pays for physician and non-physician services, outpatient hospital services, durable medical equipment, diagnostic tests, and various other medical services and supplies not covered under Part A. Coverage and reimbursement for Home Blood Glucose Meters and their associated supplies falls under Medicare Part B. All Medicare beneficiaries who are at risk for complications from diabetes may also be eligible for diabetes self-management training. What products does Medicare cover? If you're receiving Medicare Part B benefits, you can be reimbursed for most of your costs. This applies to you whether you use insulin or not. These diabetes care products from ARKRAY are covered under the Medicare Benefits: GLUCOCARD® Expression™ Audio-enabled Blood Glucose Monitoring System GLUCOCARD® Expression™ Blood Glucose Test Strips GLUCOCARD® 01 Blood Glucose Monitoring System GLUCOCARD® Continue reading >>

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