I’m facing the enrollment in Medicare in January and am trying to figure out whether it will be okay to go on Original Medicare or go into a Medicare Advantage plan. My questions relate to how hard/easy it will be to transition my T1 technology usage. Any help/advice will be appreciated from those here who have the knowledge and experience.
My situation is that I will have to get all new doctors in January so I will have to get a new endo clinic that is Medicare oriented where I have no past history with the clinic and staff. I have been T1 for over 50 years and currently use a Tandem Tslim X2 with Dexcom G5. Maintaining the usage of this technology without breaking my budget is the key issue I am trying to solve here.
If I go on original Medicare with a part D drug plan how difficult will it be to get Tandem pump supplies and Dexcom sensors/receivers given that I am currently using all of this stuff. Will I have to start as if have no history with this technology and prove that I need it (as I did a long time ago with private insurance) or is there some adjustment for someone who is already a pumper/cgm’er?
I’ve seen a lot of discussion here about the difficulty of getting pump’ed insulin billed to Medicare part B. Can someone please let me know what exactly is the cost of part B insulin (i.e., all I can find is that the cost is 20% of “something” but I cannot find out what that “something” is to figure out the real cost)? I guess I’m trying to figure out if it is worth the hassle to convince a pharmacy to charge insulin to part B or just let it go onto part D (which I can get a cost estimate for). I use about 5 vials of insulin (either Humalog or Novolog as I have used both in the past) every 3 months.
I can get cost estimates for the Medicare billing of the Tandem and Dexcom supplies. What I cannot get a handle on is how difficult the paperwork will be to start getting my supplies authorized at the beginning of the year. Any advice from anyone out there who has done this would be appreciated.
Finally - I have one last question. In my community it seems like the best Medicare Advantage program is with Aetna. Does anyone have an opinion on how supportive the Aetna insurance company is for a T1 who uses a Tandem pump with Dexcom cgm technology? Ultimately my decision is going to come down to whether or not to go on traditional Medicare or go with a Medicare Advantage plan from Aetna. I am trying to figure out which path would have the least “brain damage” and cost as far as taking care of my diabetic life.
thanks to all in advance,