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 Medicare.gov online Supplier Directory at http://www.medicare.gov/supplierdirectory/search.html 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.

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