[IP] RE: Medicare Part B
Thanks Jerry. Actually you make a good point. That is that if for some reason
someone would prefer their insulin to be billed as Part D instead of B, that's
easy to do. To have it properly billed as Part B the prescription needs to say
it's used in a pump. So if you wanted it billed as Part D you would just have
the doctor write the prescription not saying that. You have a smart strategy
given the copays of your particular plan and you know how to minimize the cost
to you. And you're really lucky that your plan covers CGMs. It's the only one
I've heard of anywhere that does. Hopefully that will change and hopefully
Congress will change the law to allow Medicare coverage of CGMs. Thank you for
your hard work on that front. Pam
From: email @ redacted [mailto:email @ redacted]
Sent: Thursday, August 27, 2015 5:26 PM
To: email @ redacted
Cc: email @ redacted
Subject: Re: Medicare Part B
Insulin Pumpers are very fortunate to have your Medicare expertise available to
them. I have a public Medicare Advantage plan with one very important extra
benefit, CGM coverage with a 20% co-pay. I have not used Part B for insulin
because the part D co-pay is $45 for a 30 day supply, which for me is three
vials. If I used Part B my co-pay would be 20% or $40 per vial. However, I am
now approaching the doughnut hole. It may be time to try to switch to Part B for
my next refill.
Medicare open enrollment for 2016 will begin October 1st and continue into
early December. This is the time to compare plans and perhaps make changes. If
you like what you have and do nothing, you will be automatically renewed.
However, there may be changes in your premiums and co-pays.
The discussion of this topic has been excellent.
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