Thursday, August 15, 2013

Medicare Changes Diabetic Supplies Program

In recent weeks, Medicare introduced a new national program that changes who and how much they will pay toward your diabetic supplies. It may mean changes for you the next time you go to replenish your testing supplies and equipment.

Beginning July 1, 2013 Medicare will pay the same amount for supplies, whether you buy them at a store or have them delivered to your home. Mail-order suppliers will need to be purchased from Medicare contracted mail-order suppliers.

If You Buy Diabetes Supplies from a Mail-Order Supplier

It’s important to find out whether your current mail-order supplier is a Medicare contract supplier. If it is, then that’s great. You can just keep on as usual. If your mail-order supplier is not contracted with Medicare, then Medicare will not cover what you buy. You need to find a contracted mail-order supplier that sells the strips you use.

Contracted suppliers must accept Medicare’s approved amount as payment in full for diabetes supplies. They can charge you only the 20% coinsurance, once you meet your deductible.

If You Buy Diabetes Supplies Locally

Some pharmacies and stores stock and sell diabetes test strips and other supplies. In this area, CVS and Sam’s Club accept the Medicare approved amount and can only bill you for the Medicare deductible or 20% co-insurance.  Other stores may charge you more than what Medicare will cover if they do not accept what Medicare pays as payment in full.

Be sure to ask the store or pharmacy you use how much you will be charged for diabetes testing supplies. If it is more than a 20% coinsurance, you may want to look for another place to buy supplies.

Want to know if your current provider is a Medicare contract provider?  You can check by visiting the online Supplier Directory at or call the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

The program is in effect in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam and American Samoa. It applies only to people who have Original Medicare. If you have a Medicare Advantage plan, you need to contact your plan for more information.

Tuesday, August 13, 2013

Three Major Medicare Myths

Myth #1: Medicare is free.
If only this were true! Medicare is not free. Just like other health insurance plans, people on Medicare may pay premiums, deductibles, co pays and coinsurance out of pocket. What each person pays will vary, depending on their specific Medicare plan, coverage and how it’s used.

Myth #2: Medicare covers everything.

Medicare covers a lot, but not everything. For example, Medicare does not cover:
-         Long-term care
-         Home health care, unless you meet very specific requirements.
-         Regular dental, vision or hearing care
In addition, Medicare will not help with the cost of personal care such as help bathing, dressing, eating or using the bathroom.

It’s also important to know that most prescription drugs are not covered under Medicare Part A or Part B. If you want drug coverage, you need to buy a Medicare prescription drug plan (Part D) or a Medicare Advantage plan (Part C) that includes drug coverage. These plans are offered by private companies that are approved by Medicare.

Myth #3: Medicare and Medicaid are the same.
While both Medicare and Medicaid are government programs and both programs help people pay for health care, that’s where the similarities end.

Medicaid is for people with limited income and resources and is governed by the states.
For more information or a refresher to bring you up to date on the latest Medicare information, please join me for one of my upcoming “Getting Started with Medicare” classes.  I’ll cover all the basics. These classes are educational only and no plan specific benefits or details will be shared.

Call to register for one of these upcoming classes:
Tuesday, September 10, 2013
Andover Library
2:00 pm – 4:00 pm
142 W. Main St.
Andover, OH 44003

Monday, September 23, 2013
Willoughby Library
7:00 pm – 8:30 pm
30 Public Square
Willoughby, OH 44094
440-942-3200 x3

Tuesday, September 24, 2013
Concord Community Center
6:30 pm – 8:00 pm
7671 Auburn Road
Concord, OH 44077
440-6394650 – contact location for fee information

Wednesday, September 25, 2013
Chagrin Falls Community Education
Class Location:  Chagrin Falls Middle School Library
7:00 pm – 8:30 pm
342 E. Washington
Chagrin Falls, OH 44022
440-274-5375 – contact location for fee information

Wednesday, October 2, 2013
Mentor Senior Center
10:00 am – 12:00 pm
8484 Munson Rd.
Mentor, OH 44060