I’m having a problem with CCS Medical regarding my yearly Part B deductible. In January, my first order for pump parts and my first prescription for insulin appear to have hit the Medicare system at approximately the same time. The effect was that, when I picked up my insulin prescription in January, Medicare was showing that my deductible had not yet been paid, so I was charged $203 when I got it. I understand enough about insurance to know that, when the deductible is owed, the consumer pays. The problem is that CCS Medical is insisting that the Part B deductible is rightly theirs, and that I still owe them $203 dollars, regardless of the fact that I already paid it to my pharmacy. They maintain that it was wrong of my pharmacy to collect the deductible.
I spent a goodly part of yesterday on the phone with both CCS Medical and Medicare. What Medicare told me is that it appears that CCS Medical’s claim was received after the pharmacy claim.
Here’s where, to me, it goes sideways. The Medicare rep I spoke to appeared to agree with CCS, that the pharmacy shouldn’t have collected the deductible. In the end, after several frustrating conversations, I was advised to ask my pharmacy to refund the deductible I had paid them two months earlier, so that I could pay it to CCS instead. Sounded kinda like bllsht to me, but I went to my pharmacy anyway and asked them if this was how this is supposed to work. They told me that “that’s not how ANY of this works!”
Now, my question for the Great Collective Intelligence here assembled is this: Is the actual equipment covered under Part B privileged for payment over the essential supplies? It seems to me that, in this context, a pump without insulin is useless, while insulin without a pump in inconvenient, but not impossible.
CCS Medical has told me that, until I pay them another $203, they will not fill any more supply orders for me. I’m not in desperate straits yet but I’d like to get this cleared up.
Has anything like this happened to any of you? Also, where is it written down that the equipment distributor is owed the deductible, and how was I supposed to know this?
Thank you all for any light you can shed.