Insulin pump, Medicare and changing endocrinologist

The endo I’ve been seeing is ok for routine stuff, but seems to be at a loss when anything outside the routine happens. They are definitely more than a few years behind when it comes to someone using CGMs and pumps who has surpassed the AACE/ADA targets.

They keep doing things that may have made sense once but no longer do - like a robodoc. They seem to have no interest in advancing their knowledge, skills or workflow, even if it would improve their patients health and reduce their own work load.

I appreciate how and why this can happen, but I don’t feel comfortable entrusting my professional support to someone who works like this. I’ve seen this in people who I worked with, and in doctors. Most of them left, the others retired. None of them gave advance notice, and we always had to scramble to find replacements.

So I’m starting to look for a different endocrinologist with more recent education and more actively managed patients using modern pumps. I’m fortunate that there are several endos in my area in a group practice.

Before I proceed, I was wondering what impact changing to a different endo would have on the supplies I receive under Medicare Part B, my insulin pump, CGM and the supplies.

Has someone here gone through this, when your endo left, you moved, or you changed between Medicare plans with different networks? If so, I’d appreciate it if you would share with me what your experience with Medicare was, and what year it happened.

In particular, was the new different doctor able to simply write new RXs for the same supplies from the same suppliers, or was there a need to do something else?

Thanks in advance for any information you can provide.

Historically, I have found that the ease of transition, especially to more modern technologies has very little to do with the endocrinologist and everything to do with the facility the endocrinologist works at. I am with Joslin in Boston and they have individuals dedicated to working out any bugs from prescriptions to authorizations for new or upgraded technologies. Endocrinologists just don’t have the time to deal with hardware manufacturers, pharmacies and other vendors that are needed.

I could get my diabetic care 40-50 miles closer to where I live and work, but the extra time it takes for that drive is rewarded many times over by the facility taking care of the many small and large aggravations our disease springs on us. A large facility has a support team and direct connections with all the manufacturers and distributors that allows the endocrinologists do what they do best and their staff members to handle the nasty logistics.

If you are under an original Medicare plan including Part A and B, and hopefully a supplemental plan, then you should be fine with switching to another endo. If on a Medicare Advantage Plan, issues may arise as to network that MA will cover. I don’t think that your supplies under B should be impacted. By all means switch if you aren’t getting what you need. I have an endo that I pray every day that she doesn’t leave the practice.

Your impression matches mine about doctors and facilities in general, but I was hoping for some more detailed information regarding the specifics of a transition, like whether I’d need to re-qualify for a pump or just get “paperwork” completed. If it’s mostly the latter, I’ll dig into the group’s capability, not just the doctor’s.

I’ve been self-sufficient for my diabetes care for decades, but I’m getting older, it’s harder, and I need to find support that can help compensate as my abilities continue to diminish.

When I asked for a pump and a CGM they quickly ordered them with an automatic Parachute DME orders. But I’ve had problems getting the Medicare Part B insulin authorizations submitted. When the supplies providers need continuing care certification and supply order re-authorizations for Medicare they are slow and inaccurate. I started building in extra time to allow for this, check checking to be sure the information was received, but it’s becoming a burden.

I know how busy endos are and what they don’t have time for. What every specialist should always find the time to do is stay current with their specialty and be capable of interpreting and directing the use of whatever they prescribe. Every medical support group should be reasonably current as far as best practices and limited only by resources.

Before I decided to start with a pump (promoted by the endo) I took the free continuing education courses offered for their specialty on the effective and appropriate use of them. I can tell they haven’t, more than a year later. I’ve cut doctors a lot of slack because of COVID, but I’m running out of time.

@pstud123

Because I was moving from California to New Mexico, I needed to change endos and eye specialists. I’m on Medicare with an employer-provided supplement for retirees. Blue Shield of California provides my supplement and it is a PPO.

I found switching to be easy … the new doc sent in a prescription when the old one expired … or with US Med (CGM supplies) they contacted the new endo when a prescription ran out.

I agree with others that you are somewhat at the mercy of the new office for making sure that they write “insulin for use in a pump”, for example, so that it is covered under part B.

Good luck.

John

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Thanks folks. That’s what I needed to know. I’ll start checking out other practices.

Hi This happened to me. There is no big deal. When your dmg provider needs new scripts tell them of your new endo and they will get in touch with him or her. There should be no disruption with your supplies. I to am using medicare b for all my dmg. Al