CVS refunded my Part B payment for insulin

Like many of you I have had to pay the Part B deductible for insulin, even though it is considered “durable medical equipment” and it should be covered by Medicare for those of us on the pump. My refunds are now coming through, so I thought I’d give you the following information about how it works.

So the way it works now is you pay the deductible up front to CVS.
Medicare pays their part and then United Health Care pays CVS the same
co-pay you already paid CVS. So CVS gets paid the co-pay twice.
United Health Care told me that CVS is supposed to refund your payment
back to you by check, no later than 4 weeks after United
Health Care pays the co-pay to CVS. The number at CVS to check on the
status of a refund check is: 1-800-494-4287. It gets you directly to
the third party reimbursement department.

I’m on United Health Care (AARP) but it should work for other health plans too. Hope this helps. :smiley:

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Why don’t they just wait to get the co-pay like my pharmacy does -
that’s crazy

Because they are getting a free loan from the customer.

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I didn’t get my deductibles back until I figured out how the system worked. CVS and Walmart don’t make it easy.

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I got back over $300 from one of the worst-run pharmacies I’ve ever had the displeasure to use. Those morons charged me for my strips despite me telling them I’d NEVER paid for strips on Medicare. It took over 3 months to get my money back, but I got it. never underestimate the cluelessness of the people behind the counter at pharmacies. We just dumped Walgreens for different issues. And I see I’m going to have to educate the clueless at our current pharmacy, CVS, regarding insulin for pumps. sigh.

If I understand you correctly, @Goldfish, this refund process you use with CVS only pertains to your annual Medicare Part B deductible, not the copay for the subsequent insulin purchased after the annual deductible is met.

This year, I used CVS for my insulin and tests strips using Medicare Part B. I also get Part B coverage for my insulin infusion supplies bought from Medtronic. I think my 2018 Part B deductible was incurred with one of the early year infusion set orders and Medtronic just billed me for that amount once Medicare issued its explanation of benefits.

For 2019, I will start with a new Medicare Supplement plan. Prior to this I used a pharmacy benefit that I earned from a former employer. This policy was not as good as a Medicare Supplement plan but did pay for my Dexcom supplies for several years when Medicare did not cover continuous glucose monitor and supplies.

My understanding is that in 2019, Medicare will pay 80% of the cost for my Part B supplies and the Supplement policy will pick up the 20% portion. I hope that means I will enjoy no out of pocket costs for these supplies.

Thanks for writing about this.

You are correct Terry 4. However, I have a plan F supplement and somehow it pays both the deductible and the co-pay. So I’m not supposed to pay up front or see a bill. Thanks for your reply.

Went to pickup test strips for my wife

Been getting 5 boxes of 100 each for years

They cannot do that any longer

you can only get 10 boxes of 50

yes they both add up to 500

Shaking my head

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FYI, Dexcom supplies only 50-count boxes. We get 6 boxes per month. We used to get the “standard” 3/month, but I took care of that. :slight_smile:

Thanks for the help this thread of your would give anyone goosebumps. I would like to apologize for replying very late but I thought that this could help everyone as I found it many days before while surfing over the internet and surprisingly came to a thread full of knowledge on the refund process at CVS. Adding into this thread I would like to share a link as I told before and can find all of it there on CVS Store.

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Under part D of my Medicare Advantage Plan I get 9 vials of insulin every 90 days from CVS/Caremark with a $40 copay. I called Caremark today and inquired about getting my insulin under Part B with no copay. The rep advised that I could apply for part B coverage but I would only be able to order a 30 day supply.

With regard to cost, the rep advised I needed to call Medicare. After waiting on hold for 25 minutes, the medicare rep was useless and recommended I call UnitedHealthCare (my Medicare Advantage administrator). The UHC rep was not very helpful but suggested I put in a claim for reimbursement.

My question for now is does Part B limit the insulin supply to 30 days?

I get a 90 day supply from CVS. They charge me the Part B amount but then, about 60 days later, I get a full refund. Sorry about the runaround. They should have been able to answer your question.