Medicare and no test strips with G6

So anyone else having problem getting test strips from medicare?Just switched to the dexcom G6 last month and not able to get test strips that dexcom was sending each month. Had my endo send a script for 150 test strips that they have not covered. My first G6 sensor was a nightmare and used 15 or more test strips in 24 hours. We need test strips, so what now? Anyone else having this issue?

Take a script to your pharmacy and try through them. That is what I do.

I had them send over a script, still wouldn’t go through.

Here is some information:: Blood sugar self-testing equipment & supplies
Blood sugar (also called blood glucose) self-testing equipment and supplies are covered as durable medical equipment for all people with Medicare Part B who have diabetes, even if you don’t use insulin .
Self-testing supplies include:
• Blood sugar monitors
• Blood sugar test strips
• Lancet devices and lancets
• Glucose control solutions for checking the accuracy of testing equipment and test strips
Part B covers the same type of blood sugar testing supplies for people with diabetes whether or not they use insulin . However, the amount of supplies that are covered varies .
If your doctor says it’s medically necessary, Medicare will allow you to get additional test strips and lancets . “Medically necessary” means that services or supplies are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice . You may need to keep a record that shows how often you’re actually testing yourself .
Medicare also covers therapeutic continuous glucose monitors (CGMs) approved for use in place of blood sugar monitors for making diabetes treatment decisions (like, changes in diet and insulin dosage) and related supplies . If you use insulin and require frequent adjustments to your insulin regimen/dosage, a CGM may be covered if your doctor determines that you meet all of the requirements for Medicare coverage, including the need to frequently check your blood sugar (four or more times a day) and the need to either use an insulin pump or receive three or more insulin injections per day .
If you have questions about diabetes supplies, call 1-800-MEDICARE (1-800-633-4227) . TTY users can call 1-877-486-2048 .
I would call my insurance provider. See what the glitch is. Good luck. Nancy50

Thank you for the information and phone # I spoke to Walgreens. They said that when they try to put it through that it asks if I am a CGM user and that I need to get test strips from my provider of my CGM supplies, I use Solara. I will have to try calling them again. Solara will be sending me my sensors from now on…Dexcom use to. I feel like I have been chasing my tail for the last few weeks.

Now that Medicare is covering G6, test strips will no longer be covered. As we all know, G6 does not eliminate the occasional use of test strips because that is in the G6 manual and we all know that sensors are occasionally wacky. So one could argue that maybe you would have a good chance of winning a Medicare appeal. I personally would just check out a meter and strips from Walmart or else buy Contour Next strips on Amazon. Fortunately I still have a stash of test strips and don’t have to deal with this yet.

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Laddie is correct. Because you’re on the G6 now, Medicare will only pay for strips and a BGM or the G6, not both. They view the G6 as being sufficient coverage to manage your treatment and pay providers a monthly price, thus not allowing any providers to bill for both. Your best bet is to find the cheapest stuff at walmart, costco, etc.

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Had a sensor that went wacky last week. That goodness I had strips. Also, what if your transmitter quits working and it takes several days to get a replacement.

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Go to Walmart and buy a set of Relion Prime. No Rx needed. You can’t be going without that now. Its needed. I forgot to stock those and I hate the idea of going into walmart, now. Maybe I can pick something up over the counter at Walgreens. There is currently community spread (widespread), so error on the side of going somewhere without a bunch of other people.

I am going to look into an appeal and in the meantime use up the strips I have. I did see the contour strips on amazon. No diabetic should be without strips. Who is making these rules for medicare?

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Not sure why you needed to use so many test strips.
I also just stared the G6 from G5 .
I’m only using two strips a day morning and evening even though it’s not asking for calibration.

Don’t even GET me started…
If you are going through traditional Medicare, they do not have any sort of predetermination/preauthorization, “pre” anything, at least as far as this issue goes. The only thing you can do is purchase test strips, send them the claim and, then, when they deny it, appeal.

Once that is denied you can fill out

There are several levels of appeals, the above form is for the first level.

Meanwhile, I would also “complain” (politely) to the appropriate Medical Director of DME
The US is split up into four jurisdictions (at least for DME).
Jurisdiction A : Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York - Entire State, Pennsylvania, Rhode Island, Vermont
Jurisdiction B : Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, Wisconsin
Jurisdiction C : Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands, Virginia, West Virginia
Jurisdiction D : Alaska, American Samoa, Arizona, California - Entire State, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri - Entire State, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, Wyoming
Jurisdiction B & C’s contractor is CGS Administrators, LLC.
Jurisdiction A & D’s contractor is: Noridian Healthcare Solutions, LLC.

The DME Medical Directors are :
Jurisdiction A : Wilfred Mamuya, M.D., PhD
Noridian Healthcare Solutions, LLC
PO Box 6727
900 42nd Street South
Fargo, ND 58108-6727
Wilfred.mamuya@noridian.com

Jurisdiction B : Stacey V. Brennan, M.D., FAAFP
CGS Administrators, LLC
2 Vantage Way - Metro Center
Nashville, TN 37228
stacey.brennan@cgsadmin.com

Jurisdiction C : Robert D. Hoover, Jr., M.D., MPH, FACP
CGS Administrators, LLC
2 Vantage Way - Metro Center
Nashville, TN 37228
robert.hoover@cgsadmin.com

Jurisdiction D : Peter J. Gurk, M.D., CPE, CHCQM
Noridian Healthcare Solutions, LLC
PO Box 6727
900 42nd Street South
Fargo, ND 58108-6727
email peter.gurk@noridian.com