I have heard that if you ask if by not using Medicare and secondary insurance the cost of drugs would be cheaper. I haven’t done this test, but probably will the next time I pick up a prescription.
I read an article about this in the recent Reader’s Digest. However with my situation I asked the pharmacist “what am I supposed to do without insulin when the vial is empty”? The response - “there’s is nothing I can do.” For whatever reason they will not even sell me a vial cash only and I’ve never had a problem before with them. Yes, they do have a problem and it is one that I can’t fix.
I get my insulin for my pump and test strips from my local CVS Pharmacy. It took me some time initially to get it set up some years ago, but I was lucky enough to find a savvy technician who was a persistent advocate for me. I haven’t had a problem since. (I do have to pay the Medicare deductible sometimes at the start of the year, but I get reimbursed because my supplemental covers it.) Looking at the benefits statement from Medicare there is quite a discrepancy between what CVS “charges” and how much they are reimbursed.
There is a CVS in a nearby town but not sure if they would be willing to bill under part B. I will have to look up their address and call them.
I don’t know why this whole situation happened in the first place. My script has 5 refills on it, I have Medicare and a good supplemental insurance. I’ve never caused the store any trouble and yet here I sit waiting for a phone call.
Never wait for phone calls! Call them. Rattle their cage! Something wafts illegal about a business refusing or hassling about billing under an approved government program.
Guess where I was this morning? At Walgreens and lo and behold - my insulin prescription was ready. It appears that once a year Medicare requires a renewal of each DME prescription. HOWEVER, no one anywhere, not even the Dr office ‘thought’ to inform the patient that this was the situation. I asked the cashier at Walgreen’s “And no one could let me know about the renewal and allowed me to nearly run out of insulin with only 20 units left in my pump reservoir”? I had all I could do to hold my temper, but I did manage it.
I hope this does not happen to anyone else, but if it does, be aware that under part B it is called durable medical equipment and supposedly that prescription has to be renewed once a year. I hope this information might save someone else the grief and anxiety that I’ve been through this past week. Thank you to all who have responded with advice, words of empathy and just being a friend. Have a good week.
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The yearly re-set raises it’s ugly head once again! There oughta be a law that says once you are diagnosed as a T1D, all questions about prescription renewals for our stuff (especially insulin!) should never have to be answered again. They could call it “The Until There’s A Cure Act” - the TUTACA …
I can see that starting next year, when I turn 65, there’s gonna be a whole host of calendar to-do’s that I will have to be responsible for.
Oy!
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Welcome to reality on Medicare. 
I am 77 and have been on Medicare for a while now. I have NO extra responsibilities. My small town pharmacist and my CDE take care of everything. Just call me lucky to have these people around me! Rural America sometimes rocks! Not often, but sometimes… 
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There is something very positive to be said for small town America. At least there people know who you are and care about doing a good job wherever they are working. You are lucky indeed.
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I’ve been getting my insulin from CVS but every time they have charged me a deductible, with no refund later. I learned just yesterday that there is a disconnect between Medicare and CVS and my AARP insurance. I was in danger of losing my pump coverage because Medicare couldn’t see that I was getting my insulin and, from their point of view, why would I need a pump if I wasn’t getting insulin. So FRUSTRATING!
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How did you discover that there is a disconnect between Medicare, CVS and AARP? Indeed that is frustrating.
I’m confused. I’m on Medicare and have never gotten an Rx for insulin. My endo GIVES me all the insulin I need. No issue here with pump coverage through Medicare.
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Hi Mayumi:
I just got some more information on this. For what it’s worth, I’ll
pass it on to you.
There are two separate lines of payment, one for the pump which AARP
rents from CCS on my behalf and one for my insulin. Every time I get
insulin I have to pay a “co-pay” to CVS. They’re supposed to refund
this co-pay to me and they did until a year and a half ago. But then
that stopped and I haven’t gotten any refunds recently.
But, I actually got a check from CCS for the last 4 months of my pump
rental. CCS had been taking that out of my checking account every month
and they finally got around to sending me a refund.
I don’t know if any of this will be helpful to you. I can see how this
is a problem for a lot of us. I’ve been trying to get this straightened
out for weeks. I think I have the pump rental straightened out but I
still have to work on getting the co-pay back from CVS.
Keep me posted on how you do. I’d love to hear from you again. And
good luck!
Eleanor
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You’re fortunate Dave that you don’t have to get your insulin from a
drugstore - it can be a real pain. CVS charges me a “co-pay” every time
I order, even though it goes through part B Medicare. They’re supposed
to refund this co-pay but that’s where the system breaks down. I
haven’t gotten a refund for 1 1/2 years.
Pump coverage is different. In my case, AARP rents my pump through
CCS. CCS has been billing me every month for the rental but then they
do send me a refund - eventually.
Eleanor
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Mayumi:
I just realized I didn’t answer your question about how I discovered the
disconnect. Just ignore the post that I put on TuDiabetes. The CCS rep.
that told me that was completely wrong! There may or may not be a
disconnect. Just a very snarled up system.
I had called CCS to inquire why I had received a check from them. I now
know that that was a refund for my pump rental which they had been
billing me for each month. That part of the system seems to be working o.k.
I’m still working on why I have to pay a co-pay for my insulin even
though it’s going through Part B Medicare.
Eleanor
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I have had several hassles with Walgreens and Part B vs. Part D insulin. First one was just after I retired, moved to New Orleans and switched from work’s insurance to Medicare. The first refill under Medicare was billed as Part D. I refused to pay and thanks to a dedicated pharmacist it got resolved before I ran out of Novolog. After that this particular Walgreens always billed Part B.
A few years later we moved to Davenport, Florida. Same hassle but it was resolved much quicker by another dedicated pharmacist. One more move about 15 miles from Davenport to Kissimmee where there was a Walgreens just across the street…same hassle. This time I went back to the Davenport Walgreens which continues to fill my Rx under Part B.
For 2018 we switched to CVS/Express Scripts for part D. I decided to skip the likely Part D/Part B with them and am sticking with the Davenport Walgreens.
The pharmacist at the Davenport gave me this Walgreens contact in case I needed to resolve Medicare insulin problems: 217-554-8766. I have not had to use it but it might be worth a try.
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I discovered the ‘disconnect’ in my case when I went to Walgreens to pick up a different prescription besides my insulin. I should have been aware of this but for some reason I was not. However insulin that is billed under part B is considered DME (durable medical equipment) and as such that prescription has to be ‘renewed’ once a year. In my case it did NOT matter that there was 5 refills left. What mattered was that the original prescription needed to be renewed. After all, I might have been ‘cured’ in that years time and Medicare would not have to pay for insulin.
The thing that was most upsetting is that there was a total lack of communication both from the doctor’s office and from Walgreen’s. No one was held accountable or took it upon themselves to help solve the issue or ease the situation. Many years ago I had a counselor tell me that "there are two kinds of workers - those that care enough to do their job in the best way possible -and- those that are just there to earn a paycheck. It isn’t hard to determine which kind of workers were involved in this situation. 
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The thing that was most upsetting is that there was a total lack of
communication both from the doctor’s office and from Walgreen’s. No one
was held accountable or took it upon themselves to help solve the issue
or ease the situation.
Mayumi, I totally agree. More communication would go a long way to
solving this vexing problem for us all.
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I am happy to report that I picked up my first batch of insulin covered under Medicare Part B from CVS. From the date of the doctor’s Rx transmitted to CVS to today was only five days. CVS, after first contacting Medicare, required that the doctor update the prescription with the ICD-10 code for diabetes type 1. I paid $0 copay.
Due to procrastination on my part and the force of habit, I could have saved almost $400/year for the last few years. I’m glad to have this in place and hope that national politics does not degrade Medicare Part B rules for insulin.
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