This question is for people in Massachusetts. I have run into a serious problem. I am on Medicare (primary) and Mass Health (secondary). I have been on a pump for 5 years. For 5 years, my Medicare Part D erroneously covered my insulin, despite the fact that they do not pay for insulin for anyone on a pump. That’s right, they didn’t catch the mistake for 5 years.
When someone is on a pump and whose primary insurance is Medicare, Part B pays for the insulin. However, they only pay 80%. I tried to get Mass Health to pick up the rest but they refused. I have been on the phone with countless people, gone back and forth with the pharmacy helping me.
If there is anyone out there who is on a pump and who has Medicare & Mass Health, please talk to me. I don’t know what to do. I cannot afford to pay 20% of my insulin costs. If I can’t straighten this out I will have to go off of a pump and back on pen shots.