I spoke with my DexCom rep and learned that test strips are expected to come from the same supplier as the one that supplies the DexCom supplies. It is a “bundle bill” (basically they get one payment for everything they have to supply).
I’m getting the feeling that Medicare/DexCom/test strips are going to be something of a nightmare to come. Given the way Medicare’s been acting, I have a strong suspicion that the one reason they have allowed the DexCom sensor over others is because the G6 can be used without glucose monitoring. So Medicare won’t have to pay for both. That is all fine and dandy but life is rarely perfect. What if you can’t get your sensors for a couple of days or something else happens. That is going leave people without ways to test their glucose and, my experience with Medicare is, if they don’t allow for it in their “policy” trying to get anything done about it takes FOREVER…
It would appear to me that the jurisdiction one lives in makes a big difference. My understanding is that private companies are contracted by the government to administer Medicare in various jurisdictions. Apparently different contractors administer their jurisdiction in different ways and read the guidelines differently as well. Am I understanding this correctly, or have I jumped to wrong conclusions?
I am on medicare so order monthly medicare package. The monthly email leads to https://store.dexcom.com
They ask a few questions about how many strips/Lancets/sensors you have left. Some people say 0 sensors left every month and receive 5, claiming that is what a CS rep has recommended to them. I don’t do that. A calendar quarter is based on 5/4/4 meaning one month has 5 weeks and will require 5 sensors and then the next 2 months will have 4 weeks and require only 4 sensors. So I always tell them I have 1 left for 2 orders (get 4 sensors) and then third order tell them I have none left (get 5 sensors). That way should there ever be an audit I come out totally clean. Medicare rarely audits but when they do they are brutal. Use similar calculation for test strips as there is more play there as additional fingersticks need to be done from time to time. Tell them I have 1 box left sometimes and get the 100 strips or tell them none left and get 150.
Your understanding is totally correct. Dexcom, in order to alleviate some of their processing issues is leaning more and more in certain states to go away from direct ship from Dexcom and only allowing Medicare supplies through approved 3rd parties. When they go third party, it appears that it takes time for 3rd parties to learn the Medicare rules. Medicare rules that you need to get a monthly kit with everything you need including Sensors, test strips and lancets. There is also an initial package that contains much more such as transmitter, receiver, battery, control solution etc.
Good question…More evidence that Medicare doesn’t seem to realize that they are dealing with human beings and human beings don’t always fit into perfect packages.
I travel a lot and in the beginning it was a real pain to schedule international trips to make sure supplies would arrive just before departure and that there would be enough to cover trip, especially if sensor goes bad. There are 3 solutions:
See if you can borrow any sensors from someone that has extras
Restart the G5 sensor so you can use it 2 weeks and do that a few times while replenishing a full month of 4-5 sensors. This will build you a supply of extra sensors for emergencies including travel.
Purchase extra sensors from Dexcom. That was their recommendation when I first started with them.
The second solution is most likely the easiest and most cost effective for you.
Just go to Walmart. A “forearm testing compatible” Reli-On meter will cost you $9.00. Strips will cost you about $20.00 for 100. Highly accurate meter and allows forearm testing…
This is not in my wheelhouse as I am not on Medicare yet. But I will say, I knew this was going to happen. And I am now waiting for all insurance companies to do the same thing. If your CGM does not need calibration, you don’t need strips.
Drives me crazy! We all know that diabetes never plays fair. Sensor goes bad, lose connection, are in a warm up phase, symptoms don’t match sensor. So many reasons to need test strips even if using a system that doesn’t need calibration.
Everyday is another battle. So very sorry this is happening. And hope you can all get what you need when you need it, not when Medicare or insurance says.
Absolutely agree! I’d not want to be w/o strips no matter the promises of the latest tech. So many things can go wrong–not least of all the possibility that shipments aren’t received in a timely fashion.
I’m not on MediCare yet and I see some responses of getting test strips from Dexcom. After a couple years of self-pay, no insurance, I am using Prodigy ‘no coding’ which is accurate enough for me at $32.19 for 300 strips from Amazon.
I had one claim for strips denied, when I opted to use my Aviva meter instead of the Contour meter that DexCom provided. I just gave up and switched to the Contour.
I was worried about this. This is why dexcom etc was approved for treatment decisions even though it should not have been imo. I will always need both due to having numbers 50-100 or more off.
