What a hassle to get insulin covered under Part B

Started with a new doctor who is great. For the last few years my previous doc would hand me insulin at each visit, saving me the grief of dealing with a pharmacy. Today, the new doc Rx’d a 90 day supply to Walgreens (ugh!). Walgreens texted me that it is delayed. I call, on hold fovever, transferred 2 times, then told Medicare doesn;t pay for insulin. AAACK! I told them that’s not true so they tried and failed to transfer me to person number 3.
A few hours later I call back, another long wait, 3 people later they said that they need a “CMN” form filled out by the doc. Called the doc, they dont have the form but hopefully either walgreens will fax them the form (another call from doc to Walgreens) or Medicare could provide it. SIGH!

oh, w/o coverage, they wanted $120 for 6 vials , good for 90 days.

Wouldn’t it be nice not to have to deal with pharmacies, and doctors over and over? I feel like lately I’ve become a full-time patient, going to appointments, getting procedures done (today was my first bladder wash with BCG). Either it’s my imagination, or I’m already getting a low grade fever from it.

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I have never had a problem getting insulin under Medicare (over 12 years) from CVSCaremark mail order. I get nine vials for three months with a Co-pay of $50.

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This Facebook post shows the phone number for the Walgreens National Medicare department. They took care of all forms for me. IMO Walgreens is one of the best pharmacies to get Part B insulin from but it is a new adventure every 90 days.

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I’ll try that number tomorrow if no luck by the middle of the day. thanks!

EDIT. Actually that is the same number that I provided to my doc’s office, given to me by my local Walgreens. I’ll let the doc’s office deal with it.

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Hope that number gets things worked out for you. If not, you should maybe call yourself. The first time I got Part B insulin the Walgreens National Medicare department called me and they had all sorts of questions to ask such as the model and serial number of the pump, when it was purchased, who paid for it, etc. The final question was “how much do you weigh?” Huh?

My Part B insulin was filled today in under 5 hours. It often takes a day or two because I think they have to contact the doctor. After I reply to the reminder email to refill the prescription, I always call Walgreens to remind them that it is Part B.

Good luck getting it worked out. The financial benefits are worth it.

I’m STILL waiting for it to go thru part B. Last I heard this morning was that the doc’s office hadn’t received the promised CMN form from Walgreens. I’m now into this 2 days and a bunch of messages and a few phone calls.

Why the doctor’s staff didn’t know how to process this is beyond me as it is an endo dealing with pumpers. At first the assistant said that it was up to the pharmacy as to how to get it thru Part B. Later on, she wrote me that they didn’t need the CMN form that they told me they needed. Then she said she’s waiting for it to arrive at her office. sigh.

What a mess

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Once you get thru all this get a copy of that form for yourself and ask the pharmacy to have one on file

My wife had to submit that form 3 times in one year and luckily the pharmacy had kept a copy

MAKE SURE YOU GET ONE - IT WILL SAVE YOU LATER ON!

and it turns out the staff at my new endo’s office either left early or wasn’t in today so it’s no wonder there was no action on the CMN form today. So now this mess will resume on Monday…stay tuned.

Are you ok with your current insulin supply?

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Yep.

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I can’t remember if I have said this yet. But the ringleader for my Part B insulin is my pharmacy, not my doctor’s office. My endo’s office submits the prescription written properly (it must be electronic) and completes whatever forms are submitted to them. But I never speak with them about it except the few times when I have needed to get a new prescription. I know that there is a form but I have never seen it. I am very lucky that my pharmacy is very competent and willing to do what it needed. Some quarters it goes better than others, but I have never had more than a 2-3 day delay. Wishing you better luck next week.

We have tried 4 pharmacies. None of them are very good which is why we have changed pharmacies so much. It is beyond annoying. Take yesterday for instance: my wife keeps track of when she can get a refill on one of her pain meds. She went to Walgreens to pick it up and they guy helping her said she had to wait 2 more days (wrong). Later in the day she got a text that it was ready for pickup so she had to make another trip over there. This is typical of that pharmacy.

One of the communication difficulties I experienced with a Walgreens pharmacy when I tried to secure test strips using Medicare Part B was a pharmacy clerk telling me that “Medicare” was not approving my strip quantity. I eventually found out that is was not Medicare that was the problem but the Walgreens Medicare department located in northern Illinois that was the source of the problem.

OOPS! Did I forget to post that I got my insulin thru Part B, finally? I got 5 vials for 90 days, free, at Walgreens after much confusion between the doctor’s staff and Walgreen’s. It was supposed to be for 6 vials, but that’s a fight to have in 90 days. I think the doctor undercalculated the number of units such that Medicare would give me 6 vials every 90 days. If I’d asked for a single month supply, I would have gotten 2 vials. But I don’t want to visit Walgreen’s any more often than necessary.

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Awesome. You live to fight another day