[Diabetes-talk] Desperately Seeking insulin Supplier UnderMedicarePart B

Tue Feb 25 13:15:51 UTC 2014

Thanks, Alan, you've told me something I was not aware of and the company 
I'm getting my pump supplies from indicated my insulin would have to go 
through what I use for my other perscriptions.  This will, thankfully, lift 
me out of the doughnut hole as well.

I too will now have to locate a company to get the vials of insulin from 
that takes Medicare coverage part B.

Eileen

-----Original Message----- 
From: Alan Lemly
Sent: Tuesday, February 25, 2014 12:58 AM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] Desperately Seeking insulin Supplier 
UnderMedicarePart B

Eileen, thanks for your reply. Actually, Medicare Part B will cover insulin
for a diabetic on an insulin pump provided their doctor writes the
prescription and provides Medicare with anything else required. I haven't
figured out what all they require but will certainly pursue the part B
coverage as this enables me to avoid the coverage gap or donut hole of Part
D.

I got the publication named Medicare's Coverage of Diabetes Supplies &
Services from the Medicare.gov website and page 13 of that document states:

"Blood sugar self-testing equipment & supplies (continued)

Insulin pumps
Insulin pumps worn outside the body (external), including the insulin used
with the pump, may be covered for some people with Medicare Part B who have
diabetes and who meet certain conditions. Insulin pumps are considered to be
durable medical equipment. "Durable medical equipment" is certain medical
equipment ordered by your doctor for use in the home."

The only conditions I've been able to determine that must be met to get Part
B coverage is a prescription from your doctor for the insulin. I'm not sure
if Medicare will ask for anything else but getting my doctor to state how
beneficial the pump is for maintaining my diabetes management and completing
any required form should not be a problem.

Alan Lemly

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
eileen scrivani
Sent: Monday, February 24, 2014 6:10 PM
To: Diabetes Talk for the Blind
Subject: Re: [Diabetes-talk] Desperately Seeking insulin Supplier Under
MedicarePart B

Alan:

It is very confusing ... For insulin, don't you mean Medicare Perscription
under part D?  Part B is for the durable goods like all the test supplies,
and other supplies for your pump, but the actual insulin is only covered
under some type of perscription drug plan coverage.

It is a horrible set up since I now will have to use 3 different companies:
1 Optum RX for mail order perscription drugs (including insulin), #2. A1
Diabetes who is one of the Medicare approved suppliers of testing supplies
and #3. Diabetes Management & Supply for the pump supplies (not the insulin)

since they have the government contract for pump supplies.

Hope this helps a little.

Eileen

-----Original Message----- 
From: Alan Lemly
Sent: Monday, February 24, 2014 4:40 PM
To: 'Diabetes Talk for the Blind' ; blind_singles at yahoogroups.com
Subject: [Diabetes-talk] Desperately Seeking insulin Supplier Under
MedicarePart B

I really can't explain the number of hours and the hoops I've jumped through
trying to get my prescriptions set up under Medicare. I was hoping to find a
mail order supplier for my insulin but since as an insulin pumper, I'm
covered under Medicare Part B, no mail order supplier will supply insulin
under Part B due to the low Medicare Part B reimbursement rate.

So my question is, where do those of you on Medicare who use an insulin pump
get your insulin? If you could tell me any hoops you had to jump through to
get this set up under Medicare Part B so I can do it on the front end, I'd
be most appreciative. I found a knowledgeable person at my local Walgreens
but she mentioned something about the doctor needing to submit a certificate
of medical necessity CMN form to Medicare and I'm having a hard time
locating one of those forms on the Medicare.gov website. I found many CMN
forms dealing with things like lift chairs and other durable medical
equipment but I already have an insulin pump and just need to get the
insulin to feed it.

Thanks in advance for any assistance you can provide.

Alan Lemly

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