Insulin for pump through Medicare

Can you check with your endo office and see if they have insulin samples to give you, until you have your appt?

It really should be up to the doctor and you, how often you “need” to see them, not MC. Maybe not all pharmacies follow the rules, depending on how their systems are set up.

I have used TacAway to remove my Medtronic CGM adhesive. Got it from Medtronic once, but now go to Amazon:

Medicare goes haywire if you go to the endocrinologist >90 days. I’ll be overseas until my 91st day, so have to make an appointment at the 65th day, so I comply. Prior to being on Medicare, my insurance company said I had to be OVER 90 days before I could visit my endocrinologist, as a cost savings measure. Go figure. I thought Medicare would be looking for ways to save money.?

1 Like

LOL (feels better to laugh than cry). When I first tried to get Part B coverage of insulin, my local CVS simply refused, and I went ahead and paid the copay I’d been paying before Medicare, my previous Blue Cross insurance now being my secondary. The copay kept increasing, so I tried again, bringing in the regulations, with no luck. Tried another CVS, and a young, helpful (and probably brand new) pharmacist was able to get Medicare to cover it, though couldn’t manage to bill the copay to BC, so I had to do that manually. But, I could not get that pharmacy to ever do it again: the head pharmacist at that store came out and said they couldn’t bill to Part B, and the young pharmacist stayed in the back, blushing. Considered trying to get pressure put on, but haven’t so far.

So, on the advice of an independent pharmacist who explained they WON’T do it, I went to a Walgreens that he said was known for dealing with Medicare. The head pharmacist there didn’t know how, but was interested in learning, and did, within a couple days, get it covered by Medicare, but, again, I had to file for the copay with BC. I did that for 2 or 3 years, until last December, when it didn’t go through again. My endo’s assistant, the store, and I, and finally the famous Walgreen’s Medicare authorization Number (888-281-0590), were finally able to work it out. Took weeks, but that’s because nothing got done unless I was standing in front of them, or at least sitting on that chair. A pharmacist, Jannel, went through a lot of effort to even get Walgreens to bill BC for the copay! I was assured that, now that they had figured it out – had only 1 other customer trying to do the Part B for insulin – it would be simpler next time.

So, this week, after asking for a renewal and getting a text that it was ready, I saw, on-line, that they had not billed Part B. I went in, the pharmacist on duty said Medicare had refused it. I went through what had gone on last time, mentioned Jannel’s name, and she came out. She called the famous number, again, they went through all the height, weight, pump serial number, last end visit, etc., that had all been done in January. Got disconnected a couple times, with the accompanying waits. But, I did walk out with the insulin after a couple hours or so.

I’m thinking that, in 3 months, I order the refill and immediately call the famous number from home to make sure they have all the info, and see if that helps any?


I had the misfortune of going to a local Safeway pharmacy that didn’t know how to process billing so they had me pay many hundreds out of pocket for myself and my wife. I knew it was wrong, found supporting documentation and after a couple of months got a large refund on my Amex account. Then I dropped them like a hot potato, switched to Walgreens which was only marginally better. Then we went back to CVS-Target where in the past we had great luck, but the lady in charge is a nut, so we reluctantly went back to Walgreens where at least they don’t stretch out the number of days between Rx’s like CVS did. We would love to find a local pharmacy that was as good for us as Target was prior to the takeover by CVS. Grrr…

1 Like

On the 88 day supply, it was explained to me once that since the strips come in a box of 100 another box of 100 would put me over by too much. So hence an “88”day supply. They had to supply an “at least” amount but could not go over by too much.

But I know at Walgreens I had one lady that would give me 2 vials a month of insulin, instead of a 20 day 1 vial. (Honeymoon phase and I didn’t need as much) She did it for several months and then I got new people that said they couldn’t do it, that it had been wrong, the insurance wouldn’t pay. So I’m assuming it can be just a 20 day supply if it is a prepackaged amount but not a 40 day amount per month.

This was private insurance but Medicare probably is the same.

I just had the doctor at the time up the prescription needed amount so I wouldn’t have to make so many trips.

My wife gets different stories from different employees at any of the pharmacies she goes to. It’s like none of them really have hard and fast rules. It’s nuts.

1 Like

Some will just not do it - corporate policy they say

nothing will change until the dogs are lapping up blood from the guillotines being used

sorry to be so graphic - that is just way it is going to have to end to get decent health care

“Policy” is code for “I don’t want to do what you want me to do”.


I just started-Medicare at the end of last year, my first insulin experience with part B was through CVS. It took 2 to 3 weeks for them to finally get it processed and for me to get my insulin. The second time I got insulin, I thought that perhaps a larger pharmacy who is more familiar with dealing with Medicare would be a better choice. I went to the local Walmart store, spoke to the pharmacy manager and within 24 hours I had my Fiasp. I’m now thinking of moving all my prescriptions over to Walmart.


CVS is a pretty large chain. I really think it depends on the pharmacist who fills the prescription. Some seem to be more adept at the paperwork involved in Medicare Part B.


Get and keep a copy of the paperwork - They had to send it 3 or 4 times for various insane reasons - on the paperwork are the right codes - they will be hard to find without the copy that was sent.

Make sure they have it on file as my pharmacy does

get and keep a copy of the paperwork


1 Like

Yes, I totally agree. That’s why I selected Walmart the second time. Much larger customer volume at Walmart than my local CVS. Hence a better chance the pharmacist had more Part B experience, which seems to have been true.

You might only figure out the source of the problem by having your Doc call in one set of Rx to Walgreens and one set of Rx to Walmart. Maybe then you can get it figured out.

Ditto ditto ditto what everyone said! Arghhhh!

Welcome to the community Rae, Thank you for joining the conversation.

After I go on Medicare, I’ll have a choice between dealing with Part B (with supplemental) and paying nothing out of pocket, or a $53 copay every 3 months. So, does saving $18/month make dealing with Part B worthwhile?

That depends upon your personal finances. For some it matters little; for others, it makes a big difference. For you to decide.

As Willow4 says, there are a lot of variables that are different for each person. I am MDI so my insulin is covered under Part D of medicare but by buying my insulin in Canada, I save several $1000’s a year on combined copays and premiums by paying for my my insulin out of pocket as I get US list price of about $8,000 for $800 in Canada. I only live 2 1/4 hour drive to the border so in my case, that is what makes financial sense for me.