I use CVS and have had the same problem. However, its store dependent. I recently moved from NYC to the Connecticut countryside and noticed two things: 1) The staff were nicer and 2) My longest wait was 5 minutes… I typically wait 1-3.
I was ready to leave CVS, but decided to stay after having this experience.
S
Thank-you to all who participated in this thread. While the not answering the phone behavior is irritating, I can understand it happening in the context of under-staffing.
I walked over to the pharmacy to check on my order and was surprised when the pharmacist who worked on my order for the last three weeks told me that he could hand over the strips to me later today. I went back in a few hours later and left with 300 Contour Next glucose test strips without any copay! It was fully covered under Medicare Part B with the help of my supplemental insurance.
The one thing that the pharmacist said was that the doctor ordering “test three times per day” was key for him. When I said that the Medicare policy to cover up to 300 for three months was actually more than three times per day. He said I would get 300 strips total anyway since they would round up from 270 to 300. No sense in arguing with that!
I understand why people get tired of all run-around when trying to use your earned insurance benefits and buying a few hundred test strips out of pocket doesn’t seem too much of a penalty. But health care is expensive – I just had to lay out $175 for the first of two shingles vaccinations.
My Rx is written for a full year so I don’t anticipate this struggle at the refill stage. Thanks again for your interest!
Glad to know that you had success. The key will actually be whether Medicare actually pays for them. I was one of many people who got test strips from Walgreens several times after Dexcom was also supplying them. They were ultimately denied and Walgreens had to absorb the cost. Of course it was a slightly different issue because they were denied because of “double dipping” since Dexcom was providing them. But you give me hope that I may be able to keep getting Contour Next strips once I use up my stash of expired strips.
You beat me to the punch. I just returned to my computer with that thought. This thing is not over until Medicare pays. That’ll take a few months. We shall see!
But if Medicare won’t pay, you will not be responsible. So it’s a win.
You’re right but I’m more interested in sustaining an ongoing relationship, a win-win relationship that can last. That’s the prize for me.
Things are so much different than when we were kids, Terry! The thought that a pharmacist and customer had a continuing connection was great back then. I remember the pharmacist in my home town knowing my parents on a very direct basis because my parents came in every month to buy insulin for me. It’s super hard to make this sort of connection today.
The closest I come to this right now, is the Walgreen’s Specialty Pharmacy that does my CGM sensors. I first got hooked up with them when my large endo’s office recommended them, and they’ve been through two insurance transitions and were by far the most useful source of advice on authorizations through those transitions. I’m almost always dealing with them by phone (it’s actually most common that they call me when it’s time for a refill) but I’ve been there a couple times in person and I’m quite impressed that I see or talk with the same staff member each time.
Does this Specialty Pharmacy make a claim against Medicare Part B for your CGM supplies? Do they also process Rx supplies for other Part B eligible items like insulin and test strips?
I’d love to consolidate all my Part B business to one supplier. Right now I use three suppliers, one for insulin and strips (CVS), one for CGM supplies (US Med), and finally one for my pump supplies (Medtronic).
I have insurance through my employer (not medicare) but I have visited this pharmacy a couple times in person and I know they do a lot of business not just in CGM’s, but also pump supplies, test strips, etc. I don’t know anything myself about Part B vs Part D but I’m sure this specialty pharmacy would know how to work the system.
Dumb question: I’m not sure how many test strips use a month, but would you ever consider just paying out of pocket? With my private insurance I have a $20 copay on any shipment of test strips (no matter what the size) and because I have a CGM I use very few test strips, to the point where it almost makes sense for me to just buy some cheap-o store brand test strips (100 for $18) with no insurance involved, instead of using insurance which will be $20 out of pocket.
I use about three strips per day or about 100/month. I prefer test strips shown to be accurate. The Accu-Chek (Roche) and Contour Next (Ascensia, formerly Bayer) are brands that I would trust.
Why should I pay for test strips out of pocket when I have earned a benefit that pays for them? At my current usage rate, I’ll use about 1200 strips each year. Buying Contour Next strips on Amazon at current prices, I would spend about $456 per year. This is enough money for me to justify my efforts.
Some people have given up on the process and choose to test very little. They often conclude, “My Dexcom G6 does not require any calibrations so why should I test at all?” In fact, I’ve read many comments online where people take pride in the fact that they don’t poke their fingers anymore. I couldn’t disagree more with this sentiment.
My ongoing Loop insulin dosing is based on the every five-minutes CGM value. My CGM is overall fairly accurate but I can’t completely trust it. When a CGM value motivates me to consider treatment with either insulin or fast-acting carbs, I will almost always finger-poke to confirm.
I’ve been burned way too many times treating off of a CGM value, only to discover later that it was wrong in a meaningful way. Even Dexcom counsels in its G6 User Guide page 175, “When in doubt, get your meter out.”
So sorry for your difficulties getting test strips from CVS. Currently I am on a Medicare Advantage plan from United Healthcare (AARP Walgreens) and I get up to 100 strips per month with $0 copay. I order through the Walgreens app. So far I have been fortunate and haven’t had any problems. My Dexcom sensors come from a durable equipment supplier, Byram Healthcare, and that has been working well.
I’m glad that you are getting the diabetes supplies needed for maintaining good health. I know many people are satisfied with Medicare Advantage (MA) Plans. I believe, however, that those plans and their benefits may change and work against you in the future. Did you know that MA administrators can change what they charge and what they cover (within certain limits) whenever they choose?
MA plans are not Medicare! They are private insurance plans that meet certain basic requirements that Medicare publishes. These requirements contain enough wiggle room for the private insurers to materially change coverage that might work against you over time.
MA plans are popular with the younger (generally healthier) cohort of retirees. Very few seniors, if they endure some expensive medical diagnosis, will stick with a MA plan. I believe that this happens by design. MA administrators do not want the sicker cohort in their insured base.
So, if a significant adverse diagnosis occurs, the retiree switches back to traditional Medicare but, unfortunately, they cannot sign up for a supplemental plan (Medigap insurance) without going through underwriting. Underwriting will not likely let anyone with diabetes, much less dementia or heart disease, into a supplemental plan.
When you first turn 65, you are eligible to sign up for a supplemental plan without underwriting consideration. That happens to be the period when MA plans use their massive marketing influence to entice people into their orbit.
There are many people who love their MA plans but do you trust the insurance company to support you when you suffer a significant health setback?
And even if your health might qualify you for supplemental coverage, the premium for that coverage will go up, by a lot. That opens the retiree up to paying for 20% of possibly expensive covered procedures.
Again, I’m happy that your MA plan is giving you what you need to treat your diabetes. I wish that for every senior living with diabetes. I just don’t trust private insurance companies! Since I am not independently wealthy, I consider them a necessary evil and will choose to avoid them when I can.
Hi Terry,
I have the good fortune to live in a state that allows seniors to return to a Medicare Supplement (aka Medigap) without going through medical underwriting or facing a higher premium. Everyone in a supplement plan is guaranteed the same rate no matter their age or health status. So if I am dissatisfied with my MA plan, I switch back to traditional medicare with a supplement plan and a plan D plan. There are only a handful of states that allow this, mostly in the Northeast. Of course, supplement rates are generally higher because underwriting has to price their plans accordingly.
I researched Medicare and am aware that many people leave MA plans as they get older and sicker. Also, MA plans have limited networks of doctors so one needs to take that into consideration too. If I traveled frequently, traditional Medicare with a supplement would be preferable because I could see any doctor in the United States who accepts Medicare. Moreover, If I lived in a state where one could be denied a supplement after the initial enrollment period or charged a much higher premium, I would not have risked the MA plan and would have remained with the supplemental plan I chose when I first became Medicare eligible.
For the majority of the US, my recommendation would concur with yours. Here, I can sample a different plan each year if I choose to do so, without penalty.
I enjoy reading your posts because they are well researched and communicated clearly. You are helping many of us manage our diabetes better. Thank you.
That’s a senior friendly policy! What state do you live in? Too bad that all states don’t allow this flexibility. As it sits now, if someone does not live in one of the states that you describe, they are essentially held hostage if their health changes.
I live in Oregon and we enjoy the ability to switch to another Medigap policy around our birthday each year while avoiding a trip through underwriting. Unfortunately, Oregon’s birthday rule does not enable one to switch between traditional Medicare/supplemental plan and Medicare Advantage. Your situation sounds ideal!
I’m glad my writing helps you. It helps me, too! Your comment taught me something today.
We live in Idaho and have kept the WA ST plan, which my husband has. We pay over $800.00 a month for a plan which covers dentistry, eyes, and hearing too, We heard about all of the much less expensive plans, but didn’t want our choice of doctors limited. We talked to two different individuals who went through all the plans with us and helped us to realize that we would maybe only save $100.00 a month by switching plans, and we would have more headaches.
We were both quite healthy until we tuned 60 and I had had type 1 for 50 yrs. The last 12 years have been rather dreadful with 5 cancers, and my complications from diabetes. I won’t bother you with a full list of our health problems, but all were unexpected.
You never know what the future holds even though we are both thin, both exercise a lot, and we both eat well all of the time. We did not see this coming. With 2 of my husband’s difficult cancer operations performed in a different state using well known specialists we never paid a penny. We had no extra worries because of medical bills. Last year our supplemental plan paid $7,000 for his newest hearing aids.
We realize that we are extremely fortunate that we can afford the premiums which continue to increase yearly. At least we can take it off of our taxes. We have always been very careful with money and have been together for 55 yrs.
It is expensive to be ill. Also we never smoked, and all of our long lived parents never had cancer. S—t can happen no matter how hard you try.
Marilyn, it sounds like you and your husband made some good insurance choices. Your natural caution has rewarded you and protected you from financial stress in addition to health troubles.
You managed your risk well by selecting an appropriate insurance option. Buying insurance is tricky as using common sense to make a decision can sometimes work against you. And listening to the person who is selling the insurance doesn’t always work out well, either.
I live in Connecticut and I am grateful for the flexibility. Medicare and all its options are incredibly complex and abstruse. No wonder seniors make mistakes and suffer penalties, or even inferior healthcare by making a suboptimal choice.
Here are some of the “guaranteed issue” rules for the various states. Unfortunately, there is no uniformity across state lines which makes the process even more complicated.
You mention this several times. How easy is it to compare plans and know if they are equal or lesser??
2+ years to go for me, but like to follow discussions on medica
As for CVS, I picked up 2 RX last week, no charge since I maxed insurance. They were so busy, they did not confirm to system that I picked them up. So now I keep getting reminder texts to pick them up.
Has your doctor sent a prescription to CVS for test strips? CVS will only dispense 300 strips for a 90 day period under Part B–even if your doctor writes the script for more. You will need a prescription to obtain the strips and lancets under Part B.
CVS pharmacies have been understaffed for years; now they are dealing with severe staff shortages and COVID practices. I’ve waited 20 minutes on hold (and gave up). Add to that that CVS’ automated voice system, website and text messaging don’t mesh with each other.
I opted to go to Walmart for my test strips and lancets and that has worked well for the past 3 years. (I’m in a small community, so not many choices for larger pharmacies.)
Yes, in fact he has sent the Rx more than once. He ordered 300 strips to cover three months, the exact quantity and time frame specified in Medicare policy. I think in the end, he may have changed it to “test 3x/day” in order to make the pharmacist happy.
Last Wednesday (12/8) I picked up my order of 300 Contour Next test strips. The pharmacist said that the order quantity of 270 (3/day x 90 days) was rounded up to 300 strips. I didn’t have to pay any copay as Traditional Medicare Part B together with a supplement policy pays for Part B strips 100%.
Thanks for reporting your positive Walmart experience. Was this for Part B strips?
