Medicare and Part B insulin coverage


#41

Update, sort of. I am the one who is bugged by Dex website plus phone calls to Dex for monthly Medicare required orders vs my previous 90 day supplies.
My Dex regional rep is supposedly working to get me on email only orders, without phone calls. My conversation with her was over a week ago. And she says yes, Dex agreement with Medicare is q30 days not 90.
Overnight I got an email, telling me to go to the website to accept an order for a G6 which I did not order or want! I have a G5 and just got a new transmitter for it.
I have nothing else to say right now. Am so ticked. I will call later even though I know they are supposed to be open 24/7.
I have a busy day today so it will be evening (EST) before I will report my saga with Dex, between other activities today. Why are all the tech companies going anti-consumer now. Dex seems to be succumbing too.
And while I am whining, why is it that sometimes on tudiabetes, you can click on T1 technology on the upper left and other times you have to search for it in forums? There is sometimes a visible vertical left panel menu but it wasn’t there just now. And other times at random. Weird. Smile!


#42

I am so sorry for u that you are having all this trouble with ordering Dexcom supplies. Dang! I, for one, don’t want to be put on a G6 until after Medicare approves the software update to Control IQ for the T:slim, which in all likelihood will be my next pump. that approval may come in the middle of next year. A Dexcom regional rep warned me that if I get a t:slim now, I’d not be eligible for the Control IQ update thru medicare due to some arcane rules they have about updates and fees. It has been explained to me several times by regional reps and I still can’t wrap my head around the Medicare rules. Also, on the G5, I can’t even make use of a t:slim’s current Basal IQ feature. Medicare won’t even ship a Medicare patient a t:slim with Basal IQ. I need a spreadsheet to keep track of all the rules and caveats regarding when to get a new pump.


#43

Just talked with Dex. Two days ago a man from Dex told me I was getting a G6. Today, the woman I talked with told me I am not getting a G6!
I told her good, as I don’t want one.
The other good news is, supposedly now I have been switched to email only for my orders.

Dave44, thanks for telling me about the arcane Medicare rule as I had planned to pay out of pocket in January for a Tslim x2 to be ready for the whatever “communication” closed loop thingie.
My Medtronic 630 Medicare warranty won’t be up for about 3 more years. And I don’t want to wait that long for the night time protection of auto adjustment.
I must next call Medicare about whether they will pay for supplies if I get the x2 out of pocket when the time comes. It is things like this that make me wish to live in a country with universal health care. If not for family I would be in Canada.


#44

I’d call Tandem (sorry if I’ve earlier mentioned dexcom, when I mean Tandem) sales and ask for a regional manager. they know the rules “cold”. the salespeople know about 90-95% (in my limited interaction with them in my area) of what they should know about the rules. the regional manager seems more well-versed, AND better at communicating the various “gotchas” with Medicare and t:slim updates (basal IQ and control IQ). I’ve been getting quite an education and now prefer our communications to be via texts so that I can refer to the info they provide instead of relying on very lengthy phone call convos.

I’m so glad we didn’t just order a t:slim for my wife. it wouldn’t have the necessary software and according to Tandem she wouldn’t be eligible for even Basal IQ. At least that is the CURRENT deal. Hopefully, these rules get changed before summer 2019. (Besides which, she would need to be on the G6 to do even Basal IQ)