Will Medicare pay for insulin for the pump picked up every three months under Medicare Part B? It seems like if one did this one would have lots of bottles. Thoughts?
Depends on how your doctor writes the prescription. I get a 90 day supply - 9 vials. If I wanted, I could get a 30 day supply - 3 vials.
At most pharmacies you can pick up 90 day or 30 day supplies. 90 day is a bunch.
Don’t know if true for Medicare, but my employer plan would be lower cost when using 90 day mail order(with auto refill), compared to 30 day fills at local pharmacy which were slightly higher than 1/3x mail order cost.
Why would it have lots of bottles? End of year would have same total number of bottles.
My dr writes insulin RX as “up to XX units per day in insulin pump”. This number includes the extra insulin lost via tubing and reservoir changes.
That may calculate out to 4 bottles for each 3 months. Until this year, my plan covered 90 day supplies from local pharmacy, now can only get 30 day. So month 1 and 2 they fill as 1 vial, and month 3 I get 2 vials. This can be a problem if you start month 1 with no insulin, but in my case I had some on hand. If I chose mail order I would get 4 every 3 months.
With pumps, RX must be written to include the insulin lost via pump usage.
Insurance plans usually control how often RX can be filled and will vary.
I also get my insulin as a 90 day supply which, for me, is five bottles. As others have said, it just depends on how the prescription is written.
Getting enough test strips is way more problematic! I use up to 8 strips a day, and Medicare really balks at that, so I have to provide a log once every six months to prove I’m actually using that many. PintheA, but that’s Medicare for you.
MM 1 Yes I calculated and you are correct. Thank you.
I just save all this BS and money by ordering 10 months of insulin at a time by mail from Canada where is it is a fraction of the US cost and pay out of pocket. That allows me to get a very inexpensive drug plan although I am on Part D as I am MDI, not on pump but guess it would be similar savings on part B.
Not on Medicare yet, but I get the 90 day supply and am a firm believer in the fact that, since there’s no set dose and insulin use HAS to vary day by day based on what you’re eating, not to mention unpredictable metabolic variables like sicknesses that cause your demand to escalate, the prescription should accommodate the maximum you might need. This leads to having a backup supply for emergencies, which everyone should have anyway, and when you find you’re filling up your fridge space you just hold off filling your next order until you’ve only got a month’s backup or so.
Good explanation of what I think I was looking for.
I built a large supply room on the main house. So i can store my 14 year 3 month supply of insulin. I plan on selling the expired bottles on Ebay for the insulin vial museum someday.
I guess it’s due to regulations in the US, but in my opinion it’s totally unnecessary to require doctors to write prescriptions for insulin every 90 days. Diabetes is not going to be cured any time soon, dosage is variable and determined by the patient, and limiting insulin use won’t increase safety. In my country, diabetics need a prescription for insulin only once and then they can order it basically ad libitum. Only when changing pharmacies a new prescription is required.
Every country has crazy regulations and some are even applied worldwide. Does it really make us safer to be trained every-time we board a flight on an airline how to fasten our seat belts?
My doc has written for 15 vials / 90 days. Medicare B allows this.