Hi Dave- I have been on Medicare for just over 1 year. I was diagnosed with T1D in 2006. I have used the Medtronic pump and sensor for about 8 years. Medicare covers the pump supplies but not the sensor. I like the “Threshold Suspend” feature of the 530 G pump.
Back to Medicare: The rules are absolutely crazy. I cannot refill supplies until I have only 10 days of supplies left. They must confirm this every time. Visits to the endocrinologist and the associated blood work must be done twice as often under Medicare. (Every 3 months instead of every 6 months when I was 64 years old.). Also, I have to record on paper my BG readings from my glucose meter to confirm that EVERY day I tested the exact number of times as the test strip prescription requires. So if the prescription says test 7 times per day and on Monday I test 5 times and on Tues. I test 10 times, Medicare will not pay for the refill of the prescription for some/all supplies. I have to submit this written record every 6 months to my endo. Then the endo must sign and date the written report from me. When the report is submitted to Medicare, there are actually employees who count the number of times you tested as stated on the report.
And Medicare allows 3 BG tests per day. If the endo prescribes more than 3 test strips per day, he/she needs to justify why the patient needs to test more frequently. If the endo does not respond to meet Medicare regs, Medicare will only cover 3 test strips per day.
I have gotten the supplies I need so far, but it continues to cause a lot of needless aggravation and stress. I currently get test strips through my secondary insurance because Medicare repeatedly rejected the prescription for 7 test strips /day from my doctor.
Good luck.
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