Late to the topic but I’m struggling with this right now. Being charged $105 for 3 months when I have a supplement (Medigap plan). This happened at a CVS. They could not “see” my Medigap plan, kept insisting I don’t have one (which is crazy because I can login and see all my previous transactions including a new pmp)!
I’m in Mass and have what’s called a Health New England GIC supplement, yet, I call the number on my card and it goes to CVSsilverscript which is my Part D prescription plan. I am SOOOO confused. Can anyone tell me a pharmacy in western mass. that will understand Part B and a Supplement (Medigap)?
In theory you should be able to go to the local pharmacy give them the two cards and tell them to make sure they submit it under Part B and use the Medigap insurance. If they try to charge you, make them correct it before you pick it up.
There are a couple of possible problems. While Medicare approves all sorts of things, you have to make sure your insulin is covered. Plus the specific item is. In my case I use a pen to fill my pump and a pen is not covered under Part B for pumps. There is no Medicare code/number to submit it. And in my case I use an Omnipod and it’s not covered under PART B, it’s Part D because of being a patch pump so the insulin isn’t covered under Part B either.
And of course if it’s all under the umbrella of an advantage plan, they have their own guidelines of what they cover.
It should be covered. This has to do with them running SilverScript Part D which is incorrect. When they went to look up my Health New England Medicare Supplement Plan, all they could find was my old closed Health New England from before I retired.
This isn’t new, I’m sure they’ve had pumpers complaining before. It’s clear that they didn’t run it through Medicare Part B first because it doesn’t show up on my Medicare account as all of my other claims have (including a claim for a new insulin pump)!
My doctor specifically told them it’s for a pump and my humalog is covered. I feel like I’m experiencing some sort of weird gaslighting situation. While $35 monthly won’t break me; I’m paying for my supplement which clearly states that it will pay for the $35 after Part B.
Anyone in Western Mass (Chicopee area) who can direct me to a nearby Pharmacy that understand to run through B and then my supplement; please send me a name!
