And to get insulin filled medicare must be called by the pharmacist to get an override to get insulin. Have to call a day ahead of time in order for pharmacist to wait for override.
Of course an insulin order has nothing to with it but medicare still demands the call and override.
The fact that libre is not good enough to go with out testing does not phase them.
How the FDA ever approved it is beyond me.
I can get 300 strips per month, no sweat, with Medicare and Dexcom G5. Makes no sense that u can’t get strips when using the Libre. Someone, somewhere is confused, is my guess. Even without an Rx for 300/month, Dexcom AUTOMATICALLY ships 150 strips to Medicare patients.
My wife and I have dropped two pharmacies in the last 12-18 months (Walgreens and a particular Safeway) because of ineptitude. One of their mistakes costs me many hundreds of dollars that I eventually got reimbursed for, many months later. Some stores are staffed by incompetents.
How did the FDA approve:
[Add your own to this list]
I hope you can work around this. I am afraid of this too since dexcome is often very innacurate for me, 50-100 points off! Or more. So I would never trust it for dosing and always finger stick as well. I am not on medicare yet.
Work around is not going to be easy - you can’t even take the normal appeal path because it was not rejected - if they will not take the order it cannot be rejected - like catch 22
Are you requesting freestyle strips that are denied? Would they deny all strips, or just those?
Are you given reason for rejection?
When I go to get insulin for my wife the pharmacist must get an override from medicare because she uses the libre - they deny all strips - claiming the libre needs no fingersticks - I don’t think they paid anything before anyway. Medicare wants to make sure the order does not include strips and in the process even denies insulin until the pharmacist calls. Luckily where I go the pharmacist is willing to deal with all this - she even called from home today. It’s completely insane. Now to get insulin I have to call the day before and have them go thru all that. But insulin has to be billed the same day you pick it up and the place where I go has to work around that. She was burnt out from being on the phone but thankfully is willing to do it in the future - They deny all strips.
I was wondering about that claim and insurance. I thought there was an * next to that statement saying to do meter check when number didn’t match symptoms, or something like that. So was hoping insurance would still cover strips for that reason, and during warm-up, and when Libre fails.
Or is it just how it processes, and strips are done differently, but you can still get them.
Sure Abbott has 15 reasons when you need to test as their escape hatch. I guess medicare did not read that part
Can she get a mail order pharmacy that is better at dealing with this?
I am going to call the place she gets the libre from tomorrow
Here is the kicker - medicare or highmark never paid a dime for the strips - in all these years - medicare always paid zero when I look at the claim history
the are denying something they never paid for
I’;ve only been on Medicare for about 3 years, but I’ve never heard of them paying the vendor zero. Are you sure you are looking at exactly the correct data on your documentation?
Also no record of secondary ins paying anything - not even a claim
The pharmacy actually told me they give the strips away - maybe they get some back from the manufacturer - who knows
| Total Amount Charged: | $785.70 |
|---|---|
| Medicare Approved: | $0.00 |
| Total Applied to Deductible: | $0.00 |
| Blood Deductible: | $0.00 |
| Physical Therapy Charges: | $0.00 |
| Psychiatric Charges: | $0.00 |
| Occupational Therapy Charges: | $0.00 |
| Patient Paid to Provider: | $0.00 |
| Medicare Paid You: | $0.00 |
| Medicare Paid Provider: | $0.00 |
I just now created a medicare account to view my records on line. It shows no payment for strips at the pharmacy that were billed for over $1,300. AND, my records show repeated charges for lancets that I’ve never received. Sounds like the pharmacy is running a scam. I dropped them recently–Walgreens.
and currently, I get my strips directly from Dexcom as that’s the only way that I am able to, according to Medicare/Walgreens after much discussion when I last tried to pick them up at Walgreens. I’ll try to find detailed billing from Dexcom…no detail. Just billed each month for $251 and Medicare paid that amount, but I don’t understand why it shows another $50 to be paid by co-insurance. That sounds as if the billed column isn’t the full amount??
looking over the Medicare claims, I see a highly inflated bill for over $203,000 for one night stay and a knee operation. The hospital even charged over $5k for “self administered drugs” that I never took, like an inhaler for $2,400! talk about fraud. Medicare doesn’t pay for any of the “self administered drugs”.
Yep - they get zero, but now I cannot get them for zero because they don’t want to pay zero
very frustrating (re: your issue with strips not being covered)
my hospital bill from november that I mentioned, is still being processed and it doesn’t show up yet on my secondary insurance claims so I’m in the dark about they might try to charge me for bogus charges.
I’ve been getting my Freestyle Libre supplies through Byram Healthcare for some time now. Recently I tried to reorder Contour-Next test strips through my local Walgreen Pharmacy and my request was denied. So, I contacted Byram and asked about test strips. And they said Oh, we can add those on to your current order. And they did. They didn’t even need a prescription. According to them, I have to use the Precision Neo to qualify, but it provides for 100 strips per month.
Don’t know what would have happened if I had requested the Neo strips at Walgreens.