Last year, I was on a Humana Medicare Advantage plan, and I got my G7s filled at CVS no problem. Now I am on a UHC Supplement, and figuring out how to get my G7s has become very confusing as I am getting different and conflicting information from both UHC and CVS.
I chatted with UHC and was told that CVS can process my G7 through the “reimbursement” option on their end, and I would pay zero dollars. One CVS tech said, yes, that can be done. When I wen to get it filled, a different tech said the claim would not go through.
I chatted again with UHC again, and this time was told the G7 could NOT be ordered from a pharmacy, only from one of 3 medical suppliers (see below). This would include all Part B items, such as test strips and lancets.
I would prefer to deal with my local CVS, but, if I do have to use a supplier, any opinions on the following choices I have:
I have an excellent experience with US Med. Every 3 months I get a text asking me whether I want more sensors. I respond Yes. That’s it. A week later a 3 month supply of sensors arrives in the mail. Couldn’t be easier.
Just to make sure, you switched from the Humana Medicare Advantage Plan to Medicare Parts A, B, D, and a supplement, correct? The really important parts are signing up for Part B and knowing which Part D plan you picked. Part D plans with the same name can be different even within states so please name a city or zip code near your. With this information we can give you a really good answer that applies to the coverage you have.
I’ve had trouble with all of the medical supplies companies I’ve used. I don’t know of a good one. I’ve never heard of Adapthealth. I’ll check that one out. I feel certain someone on this forum mentioned several years ago that you could get Dexcom at Costco’s pharmacy. I don’t know if it’s true, but I thought I’d tell you in case that’s an option for you.
The supplement - Plan G - covers Parts A and B and I have a PDP plan under Part D. I live outside of Phoenix, AZ. One of the reasons I do not want to use mail order is because I am concerned about the heat affecting devices and medications.
If you have signed up for Medicare Part B in addition to your supplement you may order from any company that can bill Part B for CGMs.
I use Minipharmacy and they can bill Part B and your supplement for the CGMs. They aren’t perfect but since they are a small company you can actually talk to the people in charge as opposed to the outsourced call centers other companies use.
Here’s my list of DME companies. Choose carefully, some are truly awful.
Just to contrast with what others have said, Edgepark can’t be trusted with your CGM order, I get other supplies from them and every order is a nightmare. The phone reps sound like they are in hell. BLN phone reps are worse. I’ve tried Byram a few times over the years, at best they failed to ship any order, at worst I found them running scams.
CVS and some other pharmacies sell CGMs and can bill Part B for some things but so far don’t seem to be able to bill Part B for CGMs. Maybe this will change in the future
I was on UHC supplement and now UHC Medicare advantage. I have always picked up my Dexcom’s from my Walmart pharmacy. UHC tries to get me to use mail order but Walmart has been so helpful to me over the years for supplies and insulin. Would rather know they are there for me to pick up and not be dependent on the mail
I just switched from Byram to USMed due to recurring billing issues at Byram that required too much of my time to resolve. To be fair, it was difficult to determine who was at fault, my Medicare Advantage insurer or Byram.
I dropped the MA plan in favor of traditional Medicare with a supplement and drug plan. Hoping for a trouble free experience with USMed. First shipment of G7s will arrive in a couple of days. Signing up was easy and they took care of all the necessary approvals.
I have heard good things about Edwards too and for me it was a toss-up between Edwards and USMed.
I have also been with several providers. The best was Health Living Medical Supplies. My Tandem pump was supplied through them and supplies came reliably until they were purchased by Solara. (They still operate as HLMS under Solara.). I had so much trouble with them I attempted to switch to Byram (based on reviews.). I was initially told they could provide cartridges and infusion sets, but when I went to order was told by another person that they could not provide them to me in NC. I tried to work through Edgepark but that was a failure. Let me say, I have an outstanding endocrinologist, but he and his staff could not satisfy Edgepark prescription requirements. In the end, I returned to HLMS and they have reliably shipped supplies. But they will hound you to death with calls and texts beginning about 75 days after your previous order. If you respond to delay shipment for 15 days you will continue to receive calls and texts. Even after you authorize an order, you will receive calls and texts. I guess some of this is my fault; I need to restrict how they can contact me.
I started using Byram about mid 2024 but stopped as they told me that they don’t work with Medicare. I spent a lot of time on the phone and online chat to get things straightened out. Online chat is great becuase it is easy to document a discussion with them. My Doctors diabetes support person recommended Wellstart Medical ( wellstartcgm.com ) and she reports that her patients have had good luck with them. For me, they were easy to get my G6 set up and shipping was fast. It did take about a week or so for them the get medicare approval for me. So far, so good.
I have used Edgepark for my Medtronic supplies for years through regular insurance and am pretty satisfied, except every order that seem to act as if a new prescription and authorization is required. Wouldn’t a prescription once a year suffice? Anyway, I find that annoying. Each order is like the first time I’ve dealt with them. This has been going on over 7 years! Anyway,
Now on Medicare and Humana supplement, plan G, can I order from anywhere? Or are you limited? I’m inclined to stay with Edgepark except for the major production everytime I have an order.
Up thread there are multiple posts with references about supplies and Medicare coverage. That’s why I mentioned it. It was not exclusively directed to you. And, I don’t know your age. No offense intended.
