Just curious. I suspect the answer is no but I’ll ask anyway.
Did the Medicare rules treating insulin used in pumps as DME covered by Part B change in 2022?
Humana ALWAYS messes up my regular every 90-day renewals by starting to bill me as if it’s Part D. They always get it right but they also always look stupid, to me, making the same mistake every 90 days. They just made it again this week, so I thought I’d ask to see if maybe it IS now a Part D drug even for pump users.
Nope, Medicare is Part B for pumpers. Omnipod is the only exception.
If you have an Advantage Plan, they may cover your insulin differently. But if you have Basic Medicare, the policy has not changed for tubed pumps.
What I figgered. Pity the clowns at Humana haven’t completely figgered it out too! 
I think some people on Advantage Plans do better having their insulin covered through Part D. It depends on what percentage you have to pay for DME and what your Part D copays are and Donut hole considerations.
Yep. I tell Humana every 90 days that their software should ask itself “Is this guy’s refill request is coming from a pumper? Yes, it is.” So the software would know automatically to bill me as Part B. It would know that because it would also see that they routinely pay my claims for pump supplies as Part B DME as well. But no, they just keep making the same mistake over and over and over every 90 days. They look stupid to me. And I trust my health to them! 
I buy stuff from them I need to survive! Is it any wonder their administrative incompetence ——es me off?! 
[quote=“Tom_in_SC, post:6, topic:89197”]
Is this guy’s refill request is coming from a pumper?
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I’m not on medicare (yet), but when my endo writes script for insulin, she specifically includes “for use in insulin pump”. I assume she has medicare patients and has learned that it helps.
I still get long acting insulin, for back up, but usually 1 vial, and renew when it expires. Assume that would have to be Part D under medicare.
It may not make you feel better, but I get my Medicare-covered insulin from a well-known National chain whose initials are CVS. The first time with a new Humalog prescription (because Novolog was no longer part of my formulary) it took 5 visits to get it covered under Medicare Part B. Now they get it right 2 out of 3 times … but still to use Part D on occasion.
That said, I feel EXCEEDINGLY fortunate: between Medicare and my former employer’s retirement supplement I pay ZERO for insulin, cartridges, and G6 supplies. I expect that there would be a long line of folks HAPPY to make the occasional extra effort with CVS to have that amazing coverage! I fear that we may never fix medical insurance coverage in this country … but it seems shameful that we can’t do better for everyone.
Stay safe!
John
John-S2
I’d like to explore this with you a bit further, outside the forum. I’m new to the forum so I’m not sure how to send an email ONLY to you. if you’re willing and can help me with the email,details I’d be grateful. thx.
Tom
I get my (original) Medicare Part B insulin from Walgreens. My local Walgreens doesn’t stock FIASP, so it take about a week for them to verify last endo visit and bring in FIASP. Haven’t had any additional barriers or hoops to jump through over 4 vials covering more than 90 days.
Drug plan before Medicare was Express Scripts. Rx had to include Rx duration, dosage and number of vials. If dosage x duration was less the number of vials, Rx fill/refill would be reduced or the Rx held up. I was getting insulin from a bunch of dummies that can’t do math.