Medicare coverage of diabetic Supplies(test strips, lancets and other miscellaneous supplies)

Ryan
By Ryan Latest Reply 2012-08-14 00:01:32 -0500
Started 2008-08-24 11:55:47 -0500

How do some people on Medicare who are not on insulin get them to pay for more than 1 strip a day? Do I have to get my Dr. to write a letter to my Advantage plan? Or does he have to write it to Medicare? Or can he just write a Rx for the amount I need? I just got Medicare so I'm kind of new to this. What about alcohol swabs, sharps containers, new meters, lancing devices, are they all covered under medicare? And does he need to write a Rx for everything I need like the alcohol swabs(if they're covered). What happens if what I need isn't carried by my pharmacy and a pharmacy that has something i need doesn't accept medicare? Can I just buy the stuff on my Rx and get reimbursed for the supplies and will it be the amount I paid for them, or will I only get reimbursed a set amount for each item, and if so do you know what that amount is? I know lots of questions. I just got Medicare this month and haven't been to the Dr. yet. I just want to go there and be able to get what I need without having to go back. I currently test 10+ times a day. I am off my diabetes meds but my BG levels fluctuate really easily so I need to test when I wake up and before/after every time I eat and before bedtime so I know what I should be eating/doing when it comes time for my next mealtime. I've noticed so far with almost all of my Dr.'s, that they're basically clueless when it comes to insurance and coverage issues because they have their staff or billing companies handle that sort of thing, which is why I'm asking here where you guys have probably gone through all of that stuff I have to go through in the coming months/years/decades. Thanks for any help or advice anyone can give.
Aloha,
Ryan


18 replies

Hollywood 2
Hollywood 2 2012-08-13 23:56:46 -0500 Report

Medicare has come out with a new law on over-utilizing. Meaning if your Non insulin dependent they will only pay for 1 strip a day. If your on insulin they will pay for 3 times a day. Now note if your physician wants you checking for other reasons they now have to diagnosis in charts why and send a copy of chart to your DME co with your Rx and this has to be done now before your Medicare will pay for over utilization.
Hope that helped some one. I do encourage everyone to keep up with your logs daily and take to your Dr and for them to keep them in their files.

caspersmama
caspersmama 2008-10-18 02:35:12 -0500 Report

My doctor writes a presciptions for everything except alcohol swabs. I have a RX for lancets, strips, insulin, needles and even got my meter that way. I even have one for 800 mg of ibuprofen instead of taking 4 over the counter ones. The best thing to do is call the company or make an appt with the billing person at the doctor's office. They will tell you everything about what is billable and what is covered.

Ryan
Ryan 2008-08-28 09:31:34 -0500 Report

AOM, CDS? Do these companies have websites?

Goddess
Goddess 2008-08-28 19:27:31 -0500 Report

AOM.com

Ryan
Ryan 2008-08-28 22:00:36 -0500 Report

I went to AOM.com and it was a site selling broadband service. Thats oay, I just tried to sign up with advanced diabetes Supply. they have strips for all the meters I have, take medicare and seem to keep up with the newest stuff.
thanks,
ryan

daniel velazco
daniel velazco 2008-08-29 13:24:59 -0500 Report

Yes they have a web sitebut I can't find it right now. I do have te phone number for C.D.S. it is 1800-441-4156 and you can call between the hours of 8am-6pm est. Hope tis helps you.
Dan

Ryan
Ryan 2008-08-29 16:27:11 -0500 Report

Thanks… I recently tried signing up with advanced diabetes Supply. Apparently they're contacting my insurance to see what's up.

LoriJ
LoriJ 2008-08-26 10:34:45 -0500 Report

I also use C.D.S. out of Fla & they are great! They do all the paperwork & any calls that Medicare requires. I didn't have to do any more than talk to them on the phone. I found them on the internet by accident but am very happy with them. They carry all brands too I believe.
Lori

daniel velazco
daniel velazco 2008-08-27 17:07:11 -0500 Report

LORI, YES THEY CARRY ALL BRANDS OF METERS AD STRIPS. THEY ALSO CARRY BATTERIES FOR YOUR METER AND LANCET DEVICES. THE BEST PART IS THAT IT IS FREE. I'M ALSO GLAD I USE C.D.S.
DAN

Ryan
Ryan 2008-08-28 09:30:18 -0500 Report

What is C.D.S? What does it stand for? What's their contact information?

Hollywood 2
Hollywood 2 2012-08-14 00:01:32 -0500 Report

Ryan most co use that free meter but the truth is most co bill private insurance or Medicare or Medicaid for the meter. They say free because the truth is if you go with another co they cannot bill you if your ins. Has been billed in the last five years. You can only bill fit a meter every five years.

Goddess
Goddess 2008-08-25 19:54:38 -0500 Report

I'm on medicare and medicaid. I get all my supplies free through a company called AOM. I get a 3 month supply and early reminders when I'm due for my next shipment. Mine come regular mail.

Petrea
Petrea 2008-08-25 19:32:36 -0500 Report

I have been on Medicare since 1988 and on insulin since 1990. I use a company out of Florida. They do all the work for you by sending you the medicare paperwork to sign etc. and then contact your doctor and getting the prescriptions that are necessary to get your supplies. Your supplies are sent to you in the mail or by UPS, depending on the company. For me it has always been a 3-month supply. The companies will either remind you in advance to order more or have you order 2-3 weeks ahead of time so that you won't run out. I think most of the companies will work with you and help you with any of the questiions you may have.

Petrea

patti
patti 2008-08-24 15:10:19 -0500 Report

Most Drs dont know what is covered by insurance. Each plan is different. First call your prescription coverage provider, ask them what is covered under the prescription plan. also ask them if supplies are covered through them or home health agency. Ask if there is a mail order plan or can you use your local pharmacy. There are many new rules under medicare. Call and ask about how and what is covered. Then make an appointment with your doc and let him/her know what is covered. I only use alchol when I am not at home. Hopes this helps.

Ryan
Ryan 2008-08-24 20:51:18 -0500 Report

Thanks. When it comes to Medicare, you'd think that since it's so common, they'd know more than they do. But that's right. When it comes to anything regarding coverages, they don't know anything, which is horrible. Over here, we have 2 main health insurance plans HMSA and Kaiser. That's all they really need to know. All I know is that my Medicare Advantage Plan has to provide AT LEAST what Medicare does. I know they pay for up to 100 strips a month if you're on insulin and 100 strips every three if you're not. I guess I need to first find out what the other Medicare guidelines are regarding extra supplies and then see if my plan covers anything on top of that. I'd like to know if anyone knows what the Medicare guidelines are for getting more than the 100 strips every three months. I'll be looking and researching in the meantime and calling around but if anyone has any info regarding Medicare and their experiences with getting more supplies, I'd appreciate any help.
Thanks again,
Ryan

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