[Diabetes-talk] Desperately Seeking insulin Supplier UnderMedicarePart B

cheryl echevarria cherylandmaxx at hotmail.com
Tue Feb 25 16:24:38 UTC 2014


Insulin isn't covered under part B, I am also a Medical Biller you can try. If you have Part D which covers medications, it is not a durable medical supply like syringes or the pump supplies or strips.
Insulin is under Pharmacy prescriptions. If you only have part A and B, you need to get either Part D, or a medicare health plan, which this is how that works.
Places like aarp or any one of the insurance carriers out there, you will not lose your medicare, you are just electing to have medicare to be paid to that insurance company, you still have doctors and hospitals and you will have the pharmacy as well, or you can get Part D Medicare which is Prescriptions only.


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> From: k7uij at panix.com
> To: diabetes-talk at nfbnet.org
> Date: Tue, 25 Feb 2014 08:17:09 -0800
> Subject: Re: [Diabetes-talk] Desperately Seeking insulin	Supplier	UnderMedicarePart B
> 
> Why not actually insist upon talking with your doctor directly?
> 
> Mike
> 
> 
> -----Original Message-----
> From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
> Alan Lemly
> Sent: Tuesday, February 25, 2014 8:02 AM
> To: 'Diabetes Talk for the Blind'
> Subject: Re: [Diabetes-talk] Desperately Seeking insulin Supplier
> UnderMedicarePart B
> 
> That's great, Eileen. Good luck with getting your insulin under Medicare
> Part B. I'm sending my doctor yet another insulin prescription request and
> am trying my local Walgreens this time. I'll post back with the results.
> 
> Alan
> 
> -----Original Message-----
> From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
> eileen scrivani
> Sent: Tuesday, February 25, 2014 7:16 AM
> To: Diabetes Talk for the Blind
> Subject: Re: [Diabetes-talk] Desperately Seeking insulin Supplier
> UnderMedicarePart B
> 
> 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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