Medicare covers Insulin under Part B if it's used in an external pump (Medicare & You page 37). The trouble is that companies are reluctant to supply Insulin under Medicare Part B.
I've been dealing with Liberty Medical for the past year. They were able to get Medicare to pay for my Insulin in January, but since then, all requests for payments have been rejected (despite numerous appeals). I suspect that this has more to do with Liberty than with Medicare.
I called Medicare, and was given 3 local companies that deal with Medicare. The trouble is that none supply Insulin under B.
Can anyone recommend a company that would supply Insulin under Medicare B?
I get my Insulin filled at Walgreen. I have Medicare and part B covers the cost 100%. My pharmacist just faxes over a form that my doctor completes and I return to to Walgreen. I have had not problems getting Insulin. Medicare only allows a 1 month supply but that isn't a problem for me.
I spoke to the pharmacist at the local Walgreens who said that he's been working there for 20 years and he never prescribed Insulin under Part B. He was emphatic that it was Part D. A phone call to 217-554-8766, the Walgreen department that bills Medicare B for Insulin straightened him out.
Medicare allows a 3 month supply for everything else. Why only a 1 month supply for Insulin?
Dave I've been getting my insulin from OPTIUMRx for over a year. They are mail order and I get a 3 month supply. They do overnight delivery but sometimes it's a day late so I had my doc order an extra vial. They are located in KS, here's their phone # 1-866-208-7707, you can also look them up on the computer.
My local Walgreen only fills 1 month at a time for my One Touch test strips and Insulin. It is possible Walgreen chose the 1 month since I need 300 test strips a month and 6 bottles of Insulin monthly. I have actually never questioned them since it is easy for me to go through the Walgreen drive through each month. I am also pleased that the cover it 100%.
I have Medicare and a Medicare supplemental policy from Medica. When my endo decided, through the GAD-65 test, that I was or had become an LADA diabetic, there was no problem having a pump approved. Medicare and the supplemental policies usually don't cover pumps for type 2 diabetics.
My pump is covered under Durable Medical Equipment. Thus, supplies and materials to make the pump work, such as insulin, infusion sets and reservoirs are also covered under the Durable Medical Equipment clauses of the insurance policy.
Pumping has made such a difference in control, in ease of management, and lifestyle. If you can get your insurance companies to approve a pump, by all means, do so! Your companies may have limits on what you can get, but what ever they allow, get it!
I also used OptumRx up until July when they said they were no longer going to supply insulin under part B. Did you find an alternative supplier? Rick G.
