Medicare Ins

Diabetes Technology Insulin Pumps
1

Does anyone know what Medicare pays for pump, insulin and infusion kits.
I'm disabled and starting Medicare Ins in Jan. 2013.
Thanks, Matt

2

Thank you Aeon for your info. I understand that I will pay 20% of the pump rental. Can you tell me what it will cost me for the 10 infusion sets and what you pay for the insulin? Thanks so much. Matt

3

Matt-there are requirements under Medicare in order to be eligible to receive a pump. Your c-peptide has to be under a certain number and this ends up disqualifying many people with Type 2.

Kelly has a good description of these requirements on her blog: http://kellywpa.com/2010/12/27/medicare-insulin-pump-requirements/

Are you Type 1 or Type 2?

4

If you go for a c-peptide test, make sure your blood sugar is fairly low when you take the test. For some reason (which was explained to me, but I can't remember), if your blood sugar is high, your C-peptide will be high, too, even if you're a T1. Medicare has strict parameters for how low your C-peptide needs to be - I think it's below 1.5.

Ruth

5

Matt,

Look into the 3'rd party Medicare providers. My wife is type 1, and is on the Ping, she has United Health Care, we pay $28/month additional premium over and above the Medicare A&B premium. She has 100% coverage on all diabetes supplies except insulin.

You can go to

https://www.mymedicare.gov/

for a complete list of plans that you are eligible for, and their costs.

If your testing goes beyond the Medicare guidelines, you will have to jump through hoops to get it approved, but it can be done, we have to do that a couple of times a year. I just send them the summary from the pump records which satisfies them.

HTH

Jerry and (Sally)

6

Thank you , Ruth. I have also heard that.

7

Thanks Jerry and Sally. The united Healthcare supplemental policy in my area will cost me $160.00 a month plus $99.00 for basic medicare. If I choose their Advantage policy at $0.00 extra I will have to pay 20% coinsurance for my pump and supplies. They get me either way. Thanks again for your response.

8

If possible try to get a supplemental ins. that pays that out of pocket deduction.