I requested a refill of my usual 300 strips for 90 days under Medicare. Walmart had been filling the scrip routinely. They have instituted a policy that requires documentation from your doctor that you have diabetes, are on insulin, the strips are medically necessary and want your testing records/logs before they will fill the prescription. The pharmacy staff said this practice started around the first of this year and affects the first fill of strips for the calendar year and new prescriptions. This data collection is being done by an entity within Walmart and the patient has no way to contact them. The actual pharmacy can’t see what’s going on either. Walmart does not submit the prescription to Medicare until they have all this info. I contacted Medicare and they are not requesting Walmart to do this. I finally contacted my endo and requested a new prescription be sent to another pharmacy (a Walmart pharmacist also recommended that). Has anyone else encountered this yet in 2022? Perhaps Walmart no longer wants to handle these prescriptions under Medicare? In the interim, it’s affecting people’s health.
Walmart wants to see testing records?? What business is it of theirs? Prescriptions should be good enough. This makes me angry. Good for you for changing pharmacies.
They want to see logs because they need to make sure we are actually testing and not using for nefarious purposes like removing Dexcom transmitters.
Are you saying that Walmart instituted this policy? It is different than Medicare policy. Although MC document does indicate logs required for higher quantities.
Note: pdf file will be downloaded. It is from medicare.gov.
https://www.medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf
Yes, it's a new internal Walmart policy. I checked with CVS today; they do not have such a policy for orders of 300 test strips under Medicare. (CVS said Walgreens will process orders for more than 300 strips.)
Walmart said their procedure was instituted so that they have the documentation in case of a Medicare audit. Undoubtedly this new process will encourage current customers to go elsewhere and deter other future customers from using Walmart pharmacies for test strips and lancets. Maybe that's Walmart's goal?@Lynn17, may be a “new” policy for your WalMart store, but not for mine. Over 15 years ago I wrestled with my WaMart pharmacy over those test strips. They never had them ready even when I ordered refills a week earlier. They went through all kinds of gyrations, even phoning “Medicare” in my presence and trying to “get authorizations” unsuccessfully. Finally, after I got a pump and was entitled to insulin under Medicare Plan B, they really balked. When they insisted that I pay and then file for reimbursement afterwards myself, I contacted a small nearby pharmacy. They figured things out quickly and phoned me to say that they had the appropriate codes to bill under Plan B (apparently different from regular billing and, for less money). I switched my Rxs immediately and have NOT had any problems since. I believe that the problem is with the large pharmacies because they get less money from Medicare. Smaller pharmacies are willing enough, although they did indicate that they would appreciate it if I would promise to purchase ALL my medications from them. I did promise. But, since I take insulin and levothyroxine and nothing more, they really got the short end of this. But they have consistently provided me with my Medicare-paid insulin for many years. I recommend them to all who ask.
Maybe I’m just behind the times but I’m not sure this is how it works for me at my local Walmart. I don’t spend a lot of my time in Walmart so I’m not up to date.
I wear a Tandem pump, so I don’t need to test with my meter all that often. During sensor startups, of course, and anytime I have strange looking data from the pump, but I don’t need any new strips more than once or twice a year.
Several years ago I switched to the Walmart in-house Relion brand of meter and strips, and both of those were available over the counter once I found the right aisle in the store! Since I use self-checkout, I don’t even talk to a CLERK much less a pharmacist when I buy strips. At least six months or so ago, the last time I bought a box of 100 strips, that’s how I got it.
What am I doing right!? Why wouldn’t this work for anyone?
Tom, that’s a great work-around–you’ve got a good solution. It certainly fulfills your needs and without the hassle of going through a pharmacy. I’ve looked at the Walmart brand of strips and meters----MUCH less expensive than the name brand ones and, as you said, no clerks involved.
For anyone who tests more often or doesn’t use CGM and wants to use Medicare benefits, Walmart’s new policy is a huge road block. I generally pay zero for my test strips (at the first of the year I encounter the Part B co-pay, which is fine). I was able to get strips under Medicare at CVS and without the documentation that Walmart was requesting.
This is not a “NEW” policy. I was testing 10 times a day and receiving 900 every 3 months. It was requested that I supply a “log” which I did. (Easy in Excel). This policy has been in place for at least 6 years. It probably varies by Walmart locations.
I have switched to Dexcom g5s then g6 but still test about 3 times in a 10 day life of a sensor.
Folks seem to trust Dexcom. I find it is good with trends if it is calibrated. When it goes haywire it is way off. Usually 40-85 units low.
Penn: I have been getting 300 strips for 90 days under Medicare for some time at Walmart and didn’t encounter this process until 2022. Walmart’s pharmacist said it’s a new corporate policy for those getting 300 strips for 90 days. You are correct, if someone gets more than 300 strips for a 90 day supply, there are additional (Medicare) documentation requirements for pharmacies; that rule has been in place for quite some time. Walgreens, for example, will process prescriptions for more than 300 strips for 90 days under Medicare upon completion of additional paperwork per a CVS pharmacist.
I just obtained 300 strips for a 90 day supply at CVS; no additional paperwork, no logs needed.
I have not had any problem with my Walmart here. Hopefully I won’t.
Looks like the cutoff is more than 300 for 90 days. Additional documentation is the log with date , time and BS reading.